Address: 150 N. 18th Avenue Phoenix, Arizona 85007

Salary: $52,000 - $55,000 

Grade: 20

Closing Date: Open until filled

This position will case manage a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the Arizona Long Term Care System (ALTCS) member's necessary medical, behavioral health and related social service needs. This role requires in-state travel to engage with members, providers, and community resources as needed.

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:
• Monitors and evaluates ALTCS/Tribal Contractors for program compliance, includes all or some of the following as needed: comprehensive chart reviews, meetings/interviews with Contractor, contact with member for satisfaction surveys, analysis of data, writing the draft report of the Case Management Service Review findings and recommendations for corrective action, and follow-up review and approval of submitted Corrective Action Plans.
• Independently monitors one or more specialized programs such as Over-Institutional Cost, ALTCS Transitional and Pre Admission Screening, Out-of-State Placements and ALTCS/Tribal Contractor Change Requests.
• Training and technical assistance to Contractors and other personnel as needed.
• Represent AHCCCS Division of Fee for Service Management (DFSM) at meetings internally within the agency and externally. This will involve periodic in-state travel.
• Investigates and responds to member and/or policy issues with ALTCS/Tribal Contractors.

Knowledge:
• Medicaid and Medicare Federal Regulations, State Statute and Rule and policies applicable to the ALTCS and other AHCCCS programs
• Common medical and psycho-social needs of individuals eligible for ALTCS
• How specific agencies function and inter-relate (Re: AHCCCS, Center of Medicare and Medicaid Services, Arizona Department of Health Services, Department of Economic Security, Etc)
• Processes for Corrective Action Plan development, implementation, and evaluation
• ALTCS and AHCCCS program design and implementation, including case management function and responsibilities, provider network and funding sources
• AHCCCS' computer Systems: Pre-Paid Medicaid Management Information System (PMMIS), AHCCCS Customer Eligibility (ACE), including Case Management Medical and Financial eligibility, Provider and Recipient Subsystems
• Community resources relative to providers of services to AHCCCS and ALTCS clients, basic knowledge of Third Party Liability process
• Native American Tribes/programs and ALTCS policy relative to Intergovernmental Agreements (IGA)

Skills:
• Considerable skill in reviewing case documentation in order to evaluate the appropriateness of placements and service for ALTCS members
• Strong interpersonal skills in working with people of diverse cultures and socioeconomic backgrounds and those in crisis
• Effective written communication, including writing of reports and general correspondence
• Effective presentation skills in order to provide technical assistance and training to contractors and staff
• Time management and initiative with ability to work with little or no supervision
• Organization and prioritization of multiple tasks and ability to re-prioritize as necessary

Abilities:
• Assess members from a holistic perspective and psycho-social emphasis, recognizing medical, environmental and emotional conditions or barriers that interfere with the member's ability to function at his/her highest level of independence
• Collect, review and analyze data, identify trends and develop plans and methods for program improvement
• Recognize cause and effect in identified areas of non-compliance and recommend solutions
• Communicate program compliance findings in objective, non-threatening way to contractors and providers
• Read and interpret and apply complex rule and regulations.
• Ability to work Virtual Office or telecommute or both

Arizona Drivers License

Minimum: Two years of professional experience assessing the medical, social, and behavioral health needs of a member/patient and experience in coordinating and monitoring the delivery of appropriate services to meet the needs of members/patients.

Preferred: Experience working with elderly and/pr members/patients with physical or developmental disabilities.

• 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.