AHCCCS

Arizona Health Care Cost Containment System
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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

Salary: $119000 $123000

Grade: 29

Closing Date: Open until filled

The Deputy Assistant Director (DAD) of Operations for the Division of FeeforService 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 departments 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 States 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 missioncritical 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 staffs 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 postpayment 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 FeeforService 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 Directors absence ensuring continuity and effective decisionmaking.
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 Arizonas 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 oneonone 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 Governors Office legislators other state agencies tribal leaders stakeholders MCOs providers etc.
Listen assimilate and present complex information in a clear and concise manner.
Multitask in a fast paced environment where reprioritization 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 qualitydriven health services
Effectively prioritize and/or delegate work
Informed decisionmaking 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 Bachelors 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 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.