AHCCCS

Address: 801 E. Jefferson Street, Phoenix, AZ 85034

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

Salary: $76,450 - $78,100 

Grade: 22

Closing Date: Open until filled

The position is responsible, along with a team of individuals in the Operations Unit, for having a comprehensive understanding of federal and state regulation guiding the provision of managed care and for ensuring that all AHCCCS managed care organizations/contractors adhere to all applicable regulations as well as all requirements outlined in contract and in AHCCCS policy.

The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.

Major duties and responsibilities include but are not limited to:
• Represent AHCCCS at meetings with contractors and other contractor professionals; participate in special projects related to Medicaid managed care, including rules teams, fraud prevention, contract development, etc.
• Provide technical assistance to program contractors, providers, members and other internal and external customers.
• Organize and coordinate services and communication among AHCCCS divisions and program contractor administration for the purpose of identifying, resolving and monitoring program contractor management issues.
• Monitor contractor deliverables and/or conduct provider network availability/accessibility monitoring.
• Plan and conduct operational and financial reviews including review and analysis of documentation, decision review tool and format, perform interviews.
• Develop reports on the results of operational and financial reviews, complete with corrective action plans. Monitor performance of contractors.
• Interpret various administrative rules, regulations, policies, and procedures.
• Monitor and evaluate the development of new contractors who successfully bid for acute, integrated physical and behavioral health, and long-term care services.
• Prepare responses to contractors, state agencies, and others requesting technical assistance or expressing a concern or complaint related to the acute, integrated physical and behavioral health, and long-term care programs.
• Produce written policies, procedures and reports for the acute, integrated physical and behavioral health and long-term care programs.

Knowledge:
• Project management methodology
• Techniques to select a particular approach to analyze, develop or implement policy
• Statistical analysis, data analysis, and research methods
• Managed care principles and delivery systems
• Acute, behavioral health and long-term care management principles and operations
• Systems and business management principles including administration, support and financial structures and strategic planning
• AHCCCS statutes and rules
• Problem solving and technical writing
• AHCCCS contract requirements and policies, including the AHCCCS Medical Policy Manual and the AHCCCS Contractor Operations Manual
• Computer skills including Microsoft OneDrive, Word, Access, Excel, PowerPoint and Google Suite Products

Skills:
• Organizational skills that result in prioritization of multiple tasks
• Conflict resolution
• Excellent oral and written communication skills

Abilities:
• Draft, implement and interpret rules, laws and agency policy pertaining to the Medicaid managed care delivery system
• Analyze problems and develop effective plans for corrective action
• Communicate effectively with all levels of professionals, corporate and agency officers, providers and members
• Provide effective guidance and technical assistance regarding Medicaid managed care issues and the administration of AHCCCS programs
• Effectively lead and/or facilitate a team of professionals from within and/or outside the agency
• Produce effective written communication.Multi-task in a fast-paced environment.Produce work products with limited supervision

Minimum: Two - three years of experience in Medicaid service delivery (acute, long-term care and/or behavioral health services).

Preferred: Bachelors or higher degree in Public Health, Social Work or Public Administration or closely related field.

• Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees.
• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
• Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Among the many benefits of a career with the State of Arizona, there are:
• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
• Other Leaves - Bereavement, civic duty, and military.
• A top-ranked retirement program with lifetime pension benefits
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
• RideShare and Public Transit Subsidy
• A variety of learning and career development opportunities

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Lifetime Pension Benefit Program
• Administered through the Arizona State Retirement System (ASRS)
• Defined benefit plan that provides for life-long income upon retirement.
• Required participation for Long-Term Disability (LTD) and ASRS Retirement plan.
• Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period).

Deferred Retirement Compensation Program
• Voluntary participation.
• Program administered through Nationwide.
• Tax-deferred retirement investments through payroll deductions.

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov.
Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.