Medicaid Data Solutions
This unit provides a solid data foundation on which all the Bureaus and Agency depend.
Unit responsibilities include:
- Serves as the primary intake unit for all Medicaid Data Requests
- Analyses and monitoring of data related to budget and payment issues
- Reconciliation of Encounter and Financial Data in Statewide Medicaid Managed Care (SMMC)
- Calculation of reconciliations and Health plan payments
- Data exchange with internal and external entities to include the federal government, several state agencies, contractors, and universities
- Support of Senior Management policy decision making via data modeling and sensitivity analysis
- Monthly operations pertaining to managed care, including
- Identification of recipients with HIV/AIDS
- Identification of recipients with Serious Medical Illness (SMI)
- Management of data transfer to supporting actuaries
- Verification of risk scores calculated by external actuaries
- Quality assurance and management of data extracted from the Florida Medicaid Management Information System (FMMIS)
