Dispute And Appeals Manager

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profile Job Location:

Phoenix, NM - USA

profile Monthly Salary: $ 60000 - 70000
Posted on: 30+ days ago
Vacancies: 1 Vacancy

Job Summary

DEPARTMENT OF ECONOMIC SECURITY

Your Partner For A Stronger Arizona.

DES works with families community organizations advocates and state and federal partners to realize our collective vision: A thriving Arizona.

DES serves more than 3 million Arizonans. Our Mission is to strengthen individuals families and communities for a better quality of life.

DISPUTE AND APPEALS MANAGER

Job Location:

Address: Division of Developmental Disabilities (DDD)
1789 West Jefferson Street Phoenix Arizona 85007

Posting Details:

Salary: $60000 - $70000

Grade: 22

Closing Date: November 4 2025

Job Summary:

Would you like to be part of an amazing team that helps Arizonans thrive At the Department of Economic Security (DES) we strengthen individuals families and communities for a better quality of life. DES is looking for individuals that are committed to service community and teamwork. To learn more about DES please visit ; or click on the link here to view Our DES video. Come join the DES Team!

The Department of Economic Security Division of Developmental Disabilities (DDD) is seeking an experienced and highly motivated individual to join our team as a Dispute and Appeals Manager. DDD provides individuals with developmental disabilities and their families services and supports that are flexible high quality and member driven. These services provide individuals with opportunities to exercise their rights and responsibilities of independent decision-making and engagement in the community.

Applicants for this position cannot be licensed or certified by the DDD Office of Licensing Certification and Regulation (OLCR) cannot have a principal interest in or have a spouse or close family with principal interest in a DDD Qualified Vendor Agreement and cannot be employed or subcontracted by a DDD Qualified Vendor.

Job Duties:

Essential Duties and Responsibilities include but are not limited to:

Reviews and approves all proposed resolutions of service delivery claim disputes grievances and appeals (member client parent acute care and long-term care providers) before they are forwarded to the Assistant Director
Reviews and approves requests and communications between the Division and the Attorney Generals Office for claim disputes grievances appeals fair hearings litigation settlements subpoenas summons requests for records and informal and formal legal opinions
Reviews all rules regulations laws legal opinions etc. and analyzing impact on Division operations; designs and develops the process used for providers members families advocates and other stakeholders regarding claim disputes grievances appeals and fair hearings; designs and develops programs and procedures to monitor and review all acute care and long-term care programs
Provides technical assistance to acute care/long-term care providers and Division staff regarding claim disputes grievances appeals fair hearings and related federal and state regulations rules policies and procedures; and performs other additional duties as required

Knowledge Skills & Abilities (KSAs):

Knowledge of:

Department and Division programs and activities; DES Arizona Health Care Cost Containment System (AHCCCS) Arizona Department of Administration (ADOA) Department of Health Services (DHS) and other State government agencies and state service policies procedures and operations
Federal state and county laws and judicial systems; statutes rules and regulations and their development and adoption
Grievance appeal and fair hearing rules and regulations outlined in the Balanced Budget Act of 1997; acute health care policies and practices including claim adjudication fraud and abuse ethics service delivery and contract compliance
Federal and state requirements with regard to the privacy of health information; management practices and procedures; contracts management

Skills in:

Leadership in the development and implementation of administrative technical and physical safeguards to protect the privacy of health information
Oral and written communication including public speaking
Time management (e.g. planning organizing directing controlling etc.)
Developing management and operational analysis of programs and activities

Ability to:

Interpret and apply statutes and agency and division policies and procedures
Provide sound interpretation of the federal Health Insurance Portability and Accountability Act (HIPAA) that directly impacts the maintenance of health information
Analyze information and data involving appeals and claim disputes
Analyze and interpret and understand how insurance rates are developed for acute care and long-term care services

Selective Preference(s):

The ideal candidate for this position will have:

(3) years of managerial experience in human services programs or in direct support of such programs which developed knowledge of the programs and insight into their function. A Masters degree in business or public administration or closely related field from an accredited college or university substitutes for (1) year of the required experience

Pre-Employment Requirements:

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. Any employee operating a motor vehicle on State business must possess and retain a current valid class-appropriate drivers license complete all required training and successfully pass all necessary drivers license record checks. The license must be current unexpired and neither revoked nor suspended. Employees who drive on state business are subject to Drivers license record checks must maintain acceptable driving records and must complete all required driver training. An employee who operated a personally owned vehicle on state business shall maintain the statutorily required liability insurance (see Arizona Administrative Code (A.A.C.) (R.11).
Successfully pass background and reference check; employment is contingent upon completion of the above-mentioned process and the Agencys ability to reasonably accommodate any restrictions.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
In accordance with the Arizona Health Care Cost Containment System contract as defined in 42 CFR 455104 SMDL #09-001) a search for the incumbent will be conducted monthly using the List of Excluded Individuals and Entities (LEIE) and the System for Award Management (SAM).

Benefits:

The Arizona Department of Economic Security offers a comprehensive benefits package to include:

Affordable medical dental life and short-term disability insurance plans
Participation in the Arizona State Retirement System (ASRS) and long-term disability plans
10 paid holidays per year
Vacation time accrued at 4.00 hours bi-weekly for the first 3 years
Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
Sick time accrued at 3.70 hours bi-weekly
Deferred compensation plan
Wellness plans
Tuition Reimbursement
Stipend Opportunities
Infant at Work Program
Rideshare and Public Transit Subsidy
Career Advancement & Employee Development Opportunities
Flexible schedules to create a work/life balance

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

Retirement:

State employees are required to participate in the Arizona State Retirement System (ASRS) the State sponsored retirement contribution plan and the Long-Term Disability (LTD) program after a 27-week waiting period. The ASRS defined benefit plan provides for life-long income upon retirement. You will also have the option to participate in a voluntary deferred compensation program to take advantage of tax-deferred retirement investments.

On or shortly after your first day of work you will be provided with additional information about the available insurance plans enrollment instructions submission deadlines and effective dates.

Contact Us:

For questions about this career opportunity please contact Jared Dechantigny at or

The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting or Requests should be made as early as possible to allow time to arrange the accommodation.


Required Experience:

Manager

DEPARTMENT OF ECONOMIC SECURITYYour Partner For A Stronger Arizona. DES works with families community organizations advocates and state and federal partners to realize our collective vision: A thriving Arizona.DES serves more than 3 million Arizonans. Our Mission is to strengthen individuals familie...
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Key Skills

  • Compliance Management
  • Administrative Functions
  • Oversight
  • Administrative Activities
  • Administrative Tasks
  • Budget Preparation
  • Facilities Management
  • Daily Operations
  • Account Management
  • General Ledger Accounts
  • Personnel Files
  • Administrative Management
  • Financial Statements
  • Administrative Operations
  • Annual Budget

About Company

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The Arizona Department of Revenue is consistently striving towards recruiting individuals who are committed to providing quality services to the citizens of Arizona and are passionate about creating solutions to the ever-evolving decisions faced within state government.

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