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)