AHCCCS

Arizona Health Care Cost Containment System
Accountability Community Innovation Leadership Passion Quality Respect Courage Teamwork

The Arizona Health Care Cost Containment System (AHCCCS) Arizonas Medicaid agency is driven by its mission to deliver comprehensive costeffective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.

AHCCCS employees are passionate about their work committed to high performance and dedicated to serving the citizens of Arizona. Among government agencies AHCCCS is recognized for high employee engagement and satisfaction supportive leadership and flexible work environments including remote work opportunities. With career paths for seasoned professionals in a variety of fields entrylevel positions and internship opportunities AHCCCS offers meaningful career opportunities in a competitive industry.

Come join our dynamic and dedicated team.

Address:801 E. Jefferson Street Phoenix AZ 85034

All AHCCCS Employees must reside within the state of Arizona.

Salary: $62000 $67000

Grade: 22

Position will remain open until filled.

Under the leadership of the Case Management (CM) Manager this position will provide oversight of the PreAdmission Screening and Resident Review (PASRR) Program. This position will ensure that the PASRR Program is operated in alignment with Federal and State rules and regulations. The position will supervise two PASRR staff positions overseeing the PASRR Level I and Level II reviews and provider/MCO/stakeholder training efforts related to PASRR. This position will review program data identify risks/trends/opportunities and implement/oversee processes that ensure timely and accurate evaluations of individuals that are being admitted into institutional settings across the state as well as update internal/external policies/procedures as necessary to promote compliance.
The position will actively participate in CM Unit initiatives and programs and provide support to ensure the development of a fully integrated CM Unit within the ALTCS team and the Division of Managed Care. This position will engage in broader program and delivery system efforts as needed support case management and ALTCS delivery system efforts when appropriate and will lead evaluation development and implementation of applicable Federal/state regulations and other AHCCCS initiatives with support from the CM Manager.

Major duties and responsibilities include but are not limited to:
Prepares implements and evaluates implementation of operating procedures in accordance with Program rules and regulations including but not limited to monitor compliance with State & Federal regulations pertaining to PASRR as well as audits of staff work related to Level I and Level II submission reviews/evaluations
Lead development and monitoring of the program policies and procedures including performance audits to ensure conformance with federal and state laws and all legal mandates. Lead contract and policy updates pertaining to PASRR program as needed. Interpret and develop new/revise existing policies. Will attend meetings and seminars related to this position as budget allows.
Represent the PASRR team and CM Unit in internal and external meetings. Attend meeting with ISD to support PASRR Portal operations improvements and/or issue resolution. Lead content development and oversee training efforts related to PASRR (either from PASRR staff and/or use of a vendor when need arises/budget allows).
Prepares and submits a variety of administrative and statistical reports for the monitoring and oversight on areas of interest related to the PASRR Program (e.g volume of submissions accuracy evaluations timeliness of reviews Level II dispositions) Team Leader for MCO PASRR audits and focused reviews to evaluate the effectiveness of submitted documentation and to improve processes and delivery of quality care.
Manage and direct subordinate staff (work assignments setting priorities hiring discipline provide training approving leave requests and preparing evaluations). Review direct staffs position descriptions and update as needed. May serve in the absence of the CM Manager to support the broader team.
Receive and review payment requests for Level I Screenings and Level II evaluations. Ensure comprehensive documentation and monitor for budget impacts and/or unexpected trends related to PASRR expenses.
Participate in regional and/or national PASRR education webinars. Stay apprised of federal policy updates related to PASRR and adjust Program as needed to align. Will attend meetings and seminars related to this position as budget allows.
Participate and federal/state audits of the PASRR program and lead development of responses back to auditing entities (e.g. HHS OIG).

Knowledge:
Medicaid and Medicare Federal Regulations State Statute and Rule and policies applicable to PASRR ALTCS and other AHCCCS programs
Common medical and behavioral health needs of individuals needing an institutional level of care
Agency functions and interrelation (i.e. AHCCCS Center for Medicare and Medicaid Services CMS ADHS DES/DDD AHCCCS Health Plans ALTCS Program Contractors and nonMedicaid disability and aging programs)
PASRR program design and implementation including evaluation functions and responsibilities provider supports and funding sources
AHCCCS computer systems Prepaid Medical Management Information System(PMMIS) and AHCCCS HEAplus including Case management Medical and Financial eligibility Provider and Recipient subsystems PASRR Portal

Skills:
Reviewing case documentation in order to evaluate the appropriateness of placements and services for ALTCS members
Interpersonal skills in working with people of diverse cultures and socioeconomic backgrounds and those in crisis
Oral and written communication including writing reports and general correspondence
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
Microsoft Office (Word Excel PowerPoint Outlook) or comparable software program
Organization and prioritization of multiple tasks and ability to reprioritize as necessary
Program monitoring and auditing
Identifying trends risks or opportunities to improve performance/compliance

Abilities:
Collect review and analyze data identify trends and develop plans and methods for program improvement
Recognize cause and effect in identified areas of noncompliance; evaluate program performance and resolve problems of noncompliance
Communicate program compliance findings in an objective nonthreatening way to contractors and providers
Read interpret and apply complex rules and regulations
Effectively problem solve issues as they arise
Engage staff and provide constructive feedback on work assignments

Minimum:
Four years professional experience related to health programs and/or behavioral health evaluation appropriate to the assignment which includes program planning or administration; a Bachelors degree in a field appropriate to the assignment may substitute for one year of the required experience.

Preferred:
Bachelors Degree in Social Work or other related healthcare field.

One or more years working in a managed care environment.

One or more years of supervisory experience.

Successfully pass fingerprint background check prior employment verifications and reference checks; employment is contingent upon completion of the abovementioned process and the agencys 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 R210207.12.

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:Drivers License Requirements.

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

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 parttime employees)
Paid Parental LeaveUp to 12 weeks per year paid leave for newborn or newlyplaced foster/adopted child. Learn more about the Paid Parental Leave pilot program here.
Other Leaves Bereavement civic duty and military.
A topranked 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 fulltime or parttime 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 programhere. 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 lifelong income upon retirement.
Required participation for LongTerm Disability (LTD) and ASRS Retirement plan.
Pretaxed payroll contributions begin after a 27week waiting period (prior contributions may waive the waiting period).

Deferred Retirement Compensation Program
Voluntary participation.
Program administered through Nationwide.
Taxdeferred 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 .

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.