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

Salary: $119,000 - $123,000 

Grade: 29

Closing Date: Open until filled

The Deputy Assistant Director (DAD) of Operations for the Division of Fee-for-Service Management (DFSM) oversees key operational functions, including Claims, Utilization Review, Policy, and Provider Relations. Reporting to the DFSM Assistant Director, this role leads operational teams, ensures FFS provider compliance with AHCCCS policies and regulations, and collaborates with various stakeholders to implement initiatives and resolve operational challenges. The DAD also drives program integrity, chairs the DFSM Operational Committee, and leads efforts related to Fraud, Waste, and Abuse detection. Additionally, the position supports strategic planning, stakeholder engagement, and ensures compliance with quality review requirements. The DAD may represent the division in procurement initiatives, litigation, and assume leadership in the absence of the Assistant Director.

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.

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:
• Lead and manage DFSM operational teams, including Claims, Utilization Review, Policy, and Provider Relations, ensuring alignment with strategic goals and operational efficiency. Oversee and monitor the operational workflow to ensure timely completion of mission-critical tasks, as well as state and federal deliverables. Ensure that deadlines are met and service quality is maintained.
• Provide leadership and oversight in areas such as staff development, process improvement, training, strategic planning, project management, program development, and addressing personnel needs. Review direct staff's position descriptions and update as needed.
• Serve as a key point of contact for internal and external stakeholders, including the AHCCCS leadership team, medical directors, the Office of the Inspector General (OIG), and other key partners, fostering strong relationships and resolving operational concerns collaboratively.
• Ensure FFS providers comply with AHCCCS agreements, regulations, billing manuals, and policies. Lead compliance monitoring and corrective actions. Oversee program integrity through pre- and post-payment reviews, investigations, and serve as a subject matter expert or witness in legal proceedings. Promote provider education on and adherence to Fraud, Waste, and Abuse (FWA) detection and prevention.
• Make independent program and policy decisions on behalf of the DFSM Assistant Director, in collaboration with other divisions. Develop and review AHCCCS policies to ensure compliance with regulations and legislation. Drive policy implementation and compliance in the Fee-for-Service program operations, including AIHP and FES.
• Review and interpret federal and state legislation, assessing and providing feedback on their impact of Medicaid program efficacy and efficiency. Represent DFSM in committees, workgroups, and external forums, contributing to the development and implementation of policies and legislation affecting FFS programs.
• Support the Assistant Director in process improvements for the division, including AMS strategies, standard work development, procurement initiatives, software/technical improvements, and operational assessments. Track and evaluate the effectiveness of these efforts, adjusting as needed. Assume responsibility for the division in the Assistant Director's absence, ensuring continuity and effective decision-making.
• Support the strategic planning process for DFSM, ensuring alignment with agency goals. Track and report progress on DFSM objectives, ensuring successful completion of agency priorities and the achievement of key milestones.

Knowledge:
• Federal and state regulations relating to Medicaid and Medicare
• AHCCCS rules, regulations, programs, policies and procedures
• Claims and coding submission practices
• Health care principles including Integrated healthcare principles, Arizona’s behavioral health delivery system, Tribal/Regional Behavioral Health Authorities
• Clinical Quality and Medical Management/ utilization review methods, practices and processes
• Standards of care, especially for members who are vulnerable and/or diagnosed with clinically complex conditions
• HIPAA regulations and confidentiality
• Healthcare reform and system transformation practices
• Techniques to predict and manage personnel demands of large and complex operations

Skills:
• Strong interpersonal relation skills
• The analysis, evaluation and resolution of complex problems
• Excellent interpersonal skills in one-on-one and up to large groups
• Effectively collaborating with people in position on all levels
• Effectively leading and/or facilitating a team of professionals from within and/or outside the agency
• Developing public presentations and public speaking
• Conflict resolution
• Project management to meet goals and deadlines
• Computer software (e.g. word processing, spreadsheets, databases)
• Strong oral and written communications skills.

Abilities:
• Work closely and in a positive manner with the Governor’s Office, legislators, other state agencies, tribal leaders, stakeholders, MCOs, providers, etc.
• Listen, assimilate and present complex information in a clear and concise manner.
• Multi-task in a fast paced environment where re-prioritization occurs frequently
• Produce work products with limited supervision
• Understand and communicate data/health analytics
• Effectively lead, motivate, and develop employees
• Develop and improve programs and ensure compliant, quality-driven health services
• Effectively prioritize and/or delegate work
• Informed decision-making and personal/ team accountability

Arizona Driver License

Minimum: Five or more years executive management experience providing direct supervision and overseeing the daily activities of a section OR a Bachelor's degree in a healthcare related field and two or more years of responsible work experience in medical or behavioral healthcare settings to include supervisory experience.

Preferred: Advanced degree in health care administration or a clinical degree. Experience in either programmatic or financial oversight. Arizona licensed health care professional or a Certified Professional Coder (CPC). Minimum of five years of progressive work experience in Medicaid healthcare.

• 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.)

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. Learn more about the Paid Parental Leave pilot program here.
• 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.