Salary: $45,000 - $55,000
Posting Closing Date: 08/23/2017
Professional Accountant Specialist
Division of State Group Insurance
State of Florida Department of Management Services
This position is located in Tallahassee
Pending reclassification to Career Service
The Florida Department of Management Services (DMS) is a customer-oriented agency responsible for managing various business-related functions throughout state government. Under the direction of Governor Rick Scott and DMS’ Executive Leadership Team, the agency oversees the real estate, procurement, human resources, group insurance, retirement, telecommunications, private prisons, and fleet and federal property assistance programs utilized throughout Florida’s state government. The Department of Management Services is relied upon to establish, maintain and improve the business processes used by state employees to create a better, not bigger government. The Department of Management Services facilitates the delivery of these programs and services and provides tools and training to bolster the efficiency and effectiveness of the state’s workforce. It is against this backdrop that DMS strives to demonstrate its motto, “We serve those who serve Florida.” Under the leadership of DMS Secretary Erin Rock, DMS’ employees embody four pillars on a daily basis: establishing a process-oriented mindset; challenging the status quo; creating efficiencies; and respecting state employees.
The Division of State Group Insurance (DSGI) offers and manages a comprehensive package of health and welfare insurance benefits, including a variety of health insurance options, flexible spending and health savings accounts, life insurance, dental insurance, and other insurance products. The health program covers more than 360,000 lives and provides comprehensive medical and prescription drug coverage. Self-insured claims are paid by the state at an estimated cost of $2 billion per year.
DSGI is seeking a highly motivated professional to serve as contract auditor and post payment claims vendor contract manager. This position is essential to managing all internal and external audit activities within the division, and ensuring that state funds are accounted, reported, and monitored in accordance with contract requirements, and state and federal laws. This position is also critical to identifying organizational fraud, waste and abuse risks and developing recommendations to mitigate those risks.
The incumbent will perform a variety of analyzing, monitoring, reviewing and reconciling activities for the pretax state group insurance program that includes health, life, voluntary benefits, and disability insurance to ensure audit, financial and fiscal functions of the insurance plans are performed in an accurate and timely manner and comply with all applicable state and federal laws, rules and regulations.
This position serves as an auditor and contract manager for the state group insurance program’s post payment claims audit vendor, and supports the daily operations of three business units within the Bureau of Financial and Fiscal Management. The incumbent must be knowledgeable and experienced in accounting principles and practices, auditing and monitoring, financial data analysis, data collection methods, generally accepted accounting principles, and government auditing standards.
The incumbent in this position has direct access to agency managerial employees and information of a confidential nature which has been determined to relate to employer/employee relations, collective bargaining and/or other personnel issues or budget development preparation and/or impact as defined in s. 447.203a(4) and (5), F.S.
Performs audits, compliance reviews and monitoring activities on all insurance vendors contracted by the Division of State Group Insurance offering insurance benefits under the State Employees’ Group Insurance Program, including but not limited to, State Employees’ Preferred Provider Organization Third Party Administrator and Pharmacy Benefits Manager, Health Maintenance Organizations, Life Insurance carrier, Supplemental Insurance carriers and other service providers. These activities are performed to evaluate compliance with contract specifications and applicable laws and regulations, and to validate that state funds are properly expended. Responsibilities include, but are not limited to, performing risk assessments, developing audit plans and objectives, developing procurement documents to select external audit consultants, overseeing internal and external audit projects and coordinating with outside consultants as needed, preparing audit samples, conducting and/or coordinating on-site testing, collecting and analyzing data for various projects, identifying organizational strengths and weaknesses, developing recommendations to cure deficiencies, following-up on vendors’ corrective action plans until deficiencies are cured and issues are resolved, performing monthly reconciliation of overpayment recoveries, and preparing detailed audit reports.
Manages the post payment claims contract. Serves as the Division’s liaison with the contracted vendor and tracks, monitors and documents vendor’s performance and recommends and monitors corrective action plans to address contractors’ performance deficiencies. Receives, validates and approves monthly invoices for processing. Analyzes quarterly performance guarantee reporting and assesses appropriate liquidated damages as required by contract. Recommends and monitors vendors’ corrective action plans to address contractors’ performance deficiencies. Provides user training and support as needed. Coordinates and attends quarterly vendor meetings.
Operational Support Functions:
Develops and implements standard operating procedures. Performs internal operational audits to assess compliance with standard operating procedures and internal controls established for separation of duties in the financial management areas. Examines, evaluates and reports on the adequacy and reliability of existing internal controls. Reviews information and performs analyses to identify operational strengths and weaknesses. Develops recommendations of actions to improve automated and manual systems of processing revenues and expenses, financial reporting, compliance with laws, regulations, internal policies and procedures, and the safeguarding of assets.
Prepares financial analyses, assists with annual CMS RDS reconciliation, and performs other related duties as required.
Knowledge, Skills and Abilities:
- Working knowledge of generally accepted accounting principles and standards
- Strong working knowledge of generally accepted audit standards
- Experience collecting and analyzing data and information
- Strong organizational skills
- Ability to effectively manage vendor relationships
- Ability to utilize problem-solving techniques
- Ability to work independently
- Ability to plan, organize and coordinate work assignments so that deadlines are met
- Proficiency using Microsoft Office, Word and Excel
- Bachelor’s degree or higher education from an accredited college or university with a major course of study in finance, accounting, business, risk management or a related field. OR 4 years of equivalent experience.
- At least two years of professional experience in auditing, data collection/analysis and management.
- Demonstrable contract auditing and monitoring experience is required
- Proficiency using Microsoft Office Suite
Experience auditing medical or pharmacy claims
The Department of Management Services is committed to increasing recruitment and hiring of individuals with disabilities and improving employment outcomes.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must contact the DMS Human Resources (HR) Office at (850) 488-2707. DMS requests applicants notify HR in advance to allow sufficient time to provide the accommodation.
DMS appreciates the service and sacrifices made by veterans and their family members. Further, DMS recognizes the immeasurable value veterans bring to the workplace and is committed to increasing the number of veterans that serve in its workforce.
Successful completion of background screening will be required for this position.
The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.
VETERANS’ PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.
Nearest Major Market: Tallahassee