Medical/Health Care Program Analyst

State of Florida

. Research and respond to Medicaid issues, concerns, and complaints .

Posted 10/19/2026full-timeFort Myers • Florida • United StatesMid-LevelSenior💰 $1,833 - $2,383 per weekWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicaid policies, regulations, and operational procedures while effectively coordinating with stakeholders to resolve issues and provide technical assistance. Proficient in data analysis and reporting, with strong communication skills to support clients and staff in understanding complex policies.

Highest-signal resume keywords

Medicaid Policy ExpertiseData Analysis and ReportingCustomer Issue ResolutionEffective CommunicationTeam Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data ReportingPolicy EvaluationClaims ProcessingBilling ProceduresReimbursement MethodologiesMedicaid RegulationsMedicare KnowledgeStatistical ReportingProblem-Solving TechniquesMicrosoft Excel

Soft Skills

Effective Relationship BuildingOrganizational SkillsCommunication SkillsClient CoordinationTeam Collaboration

Industry Keywords

Florida MedicaidManaged CareHealthcare ProgramsLegislative AssignmentsCommunity PartnershipsComplaint OperationsFiscal-Agent OperationsState PlanWaiversTransportation Coordination

About the role

Key responsibilities & impact

Research and respond to Medicaid issues, concerns, and complaints
Provide technical assistance to recipients and providers regarding Medicaid coverage policy
Serve as team lead for the Complaint Operations Center
Provide policy and procedural guidance to unit staff
Maintain current knowledge of Florida Medicaid laws, regulations, policies, State Plan, waivers, manuals, and amendment processes
Maintain knowledge of Medicaid fiscal-agent operations, claims processing, billing procedures, reimbursement methodologies, and provider enrollment
Maintain knowledge of Medicare and other federal and state health care programs and related innovations
Maintain knowledge of Statewide Medicaid Managed Care contract provisions, amendments, talking points, guidance, subcontractors, TPAs, and communications
Coordinate with recipients, providers, policy staff, plan management staff, and SMMC plans to research and resolve managed-care issues
Document activities in the complaint module according to protocols
Escalate overdue, non-compliant, insufficient, or inaccurate plan responses to the supervisor
Receive, research, resolve, and respond to Legislative Assignments, CorrFlow, and special assignments
Contact constituents, obtain information, make referrals, and maintain communication throughout issue resolution
Provide Medicaid policy expertise to unit staff regarding legislative assignments
Support healthcare facility closures and Medicaid terminations, including notices, family contacts, alternative placement, counseling, transportation coordination, and on-site support
Represent the Agency at government and community partnerships, outreach events, Medicaid presentations, transportation boards, community alliances, interagency teams, planning groups, HIV planning councils, and social services forums
Review pending complaints and conduct random sampling of issues assigned to Complaint Operations Unit staff
Report deficiencies to the unit supervisor for correction and coaching
Act as delegate for the Program Operations Administrator as needed

Requirements

What you’ll need

Two years of experience in developing, evaluating and/or using data reports for planning, workload analysis or monitoring purposes
Two years of Microsoft Excel or similar software experience
Three years of experience explaining policies and procedures to customers with a limited understanding of the subject matter or researching and resolving customer issues and complaints
Knowledge of methods for compiling, organizing, and analyzing data
Knowledge of problem-solving techniques
Ability to relate effectively to clients, providers, and staff of community agencies
Ability to plan, organize, and complete work assignments
Ability to establish and maintain effective working relationships
Ability to coordinate and prepare written and statistical reports
Ability to communicate effectively, verbally and in writing
Ability to travel with or without accommodation
Must successfully complete a State and National criminal history check before beginning employment
Subject to fingerprinting for State and Federal criminal records checks
Subject to reasonable suspicion drug testing
Licensure, certification, or registration: N/A

Benefits

Comp & perks

Health insurance (i.e., individual and family coverage) to eligible employees
Life insurance; $25,000 policy is free plus option to purchase additional life insurance
Dental, vision and supplemental insurance
State of Florida retirement options, including employer contributions
Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida
Ability to earn up to 104 hours of sick leave annually
Nine paid holidays and 1 personal holiday each year
Opportunities for career advancement
Tuition waivers (accepted by major Florida Colleges/universities)
Student loan forgiveness opportunities (eligibility required)
Training opportunities
Flexible Spending Accounts
Shared Savings Program for select medical services
Lower copays for prescription drugs
Health and Wellness discounts
Reasonable accommodation for candidates with disabilities
Veterans’ Preference in employment for eligible candidates