Nurse Care Coordinator
Nurse Care Coordinator
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Job Description
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 cost-effective 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 entry-level positions and internship opportunities AHCCCS offers meaningful career opportunities in a competitive industry.
Come join our dynamic and dedicated team.
Nurse Care Coordinator
Division of Fee for Service Management (DFSM)
Address: 150 N. 18th Avenue Phoenix Arizona 85007
All AHCCCS employees must reside in Arizona.
Salary: $71032
Grade: 22
FLSA Status: Exempt
Closing Date: Open until filled
Under the direction of the Integrated Services Manager the Nurse Care Coordinator is responsible for following and coordinating health care for American Indian Health Program (AIHP) members in the High Needs High Cost (HNHC) program. This position will utilize claims and clinical documentation for identification of AIHP members with unusual and complex cases and who meet the HNHC criteria. This position is responsible for organizing and facilitating clinical staffings with Tribal Regional Behavioral Health Authorities (TRBHAs) American Indian Medical Homes (AIMHs) IHS/Tribal 638 facilities and other providers in the members care team for the purpose of information sharing and coordination of care activities.
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:
Facilitates all clinical staffings for discussion of care coordination including updating each members care plan with claims and encounters data for information sharing to drive care coordination activities with the TRBHAs AIMHs IHS/638 facilities and/or behavioral health providers.
Responsible for reviewing revising analyzing and creating new claims data sets to inform clinical decisions that enable the care team to care coordinate for HNHC members.
Participates in process improvement and other special projects work groups and committees to improve efficiency of care coordination utilization management and other Care Management Systems Unit (CMSU) functions.
Participates in outreach efforts with IHS/Tribal 638 facilities including the American Indian Medical Home (AIMH) and members care team along with collaboration with DFSMs Care Management team for identification of resources as identified.
Develops reporting/tracking/trending data to present to DFSM and agency management.
Conducts contact work with the Tribes to establish rapport and close collaboration with providers and facilities including identifying and referring AIHP members for TRBHA enrollment AIMH empanelment or identification of health home.
Knowledge:
Case management care management and care coordination concepts principles and strategies
Medical and Behavioral healthcare management and delivery
Principles of medical nursing management and assessment
ICD-9/10 diagnosis coding CPT procedure coding
Medical technology computer data retrieval and input
AHCCCS program design and implementation case management functions and responsibilities provider network and funding source
Familiarity with American Indian Tribes/ programs and policy
Skills:
Problem solving-identification evaluation and initiation of appropriate action; nursing and case management assessment
Excellent communication verbal and written with FFS Providers
Organization skills to coordinate monitor and report on multiple cases simultaneously
Analytical skills to identify and correlate specific patterns initiate investigations submit findings and recommendations
Strong interpersonal skills in working with people of diverse cultures and socioeconomic backgrounds
Documentation and reporting of data and trends
Ability:
Strong ability to collaborate with others for a mutually beneficial outcome
Interpret clinical information and assess implications for treatment.
Ability to read interpret and apply complex rules and regulations
Independent decision making yet knowing when to elevate the decision
Drive long distances when required
This position has the potential to work from a Virtual Office (VO) setting or may Telecommute based on the needs of the unit and at the discretion of leadership.
Minimum: Possession of a current license to practice as a registered nurse in the State of Arizona and three (3) years of relevant experience.
Preferred: Certified Case Manager
Successfully pass fingerprint background check prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned 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 R.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 (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 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 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
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.
Required Experience:
IC
Employment Type
Full-Time
