AHCCCSArizona Health Care Cost Containment System |
| Job Location: |
| Posting Details: |
| Job Summary: |
Under the direction of the DFSM Quality Assurance (QA) Manager this position serves as the coordinator for DFSM QA activity and deliverable tracking and develop infrastructure for QA activities including developing and maintaining desk levels process and dataflows coordinating internal and external meetings and follow up develops spreadsheets reports etc. track deadlines receipts reviews and responses associated with QA deliverables maintain confidential files tracks and maintains the units leave schedules. This position has in-office duties to address member and provider communication outreach and support the unit during site visits based on the unit and divisional needs.
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:
Provide support to the CMSU CM team functions including care management & care coordination support functions such as monitoring processing & distribution of care management referrals outreach documentation & follow up as directed managing the Transition of Care ETI folder CRS referrals provider or member outreach & documentation & follow up as directed. Coordinates amongst the DFSM QA team OOD QM OIG OGC and other stakeholders including TRBHAs.
Develops desk levels spreadsheets reports and draft communications for the unit as requested. Maintain hard and/or electronic copies of files including but not limited to desk levels and process/data flow charts. Completes and maintains documentation of archived records/files. Sends external correspondence tracks timelines for requests and responses.
Schedule and provide unit support for internal and external meetings by preparing and distributing meeting materials and taking meeting minutes coordinate follow-up from discussions and track resulting deliverables and agreements. May be required to be in office two to three days a week to support teams performing provider on-site visits with appropriate documents and materials.
Works closely with other units divisions internal and external customers to facilitate quality related initiatives as directed by the QA Manager responding to inquiries as appropriate
Perform research and data gathering as requested.
| Knowledge Skills & Abilities (KSAs): |
Knowledge of:
Behavioral Healthcare Delivery Systems
Familiarity with Native American Tribes/programs
Member psychosocial and medical needs
Medicaid Medicare Federal Regulations State Statute and Rule and policies applicable to AHCCCS programs
ICD and HCPC codes
Specific geography of Arizona and New Mexico and surrounding states
AHCCCS and DFSM Policies and Procedures
Familiarity of authorization and utilization review
Medical technology computer data retrieval and input
Skill in:
Problem solving skills
Excellent verbal/written communication skills
Organizational skills to coordinate monitor and report
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 socio economic backgrounds
Documentation and reporting of data and trends
Intermediate computer skills (i.e. Microsoft Office Suite Word Excel and Google)
Ability to:
Strong ability to collaborate with others for mutually beneficial outcome
Plan organize prioritize work and multitask in a fast paced environment
Understand clinical information
Read interpret and apply complex rules and regulations
Independent decision making yet knowing when to elevate the decision
Support unit in-office based on business needs
Drive long distances when required
Ability to work Virtual Office (VO) Telecommute or both
| Selective Preference(s): |
Arizona Drivers License
Minimum: Two years of experience in a healthcare support role.
Preferred: Experience in Behavioral Health prior experience working with Tribal entities
| Pre-Employment Requirements: |
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).
| Benefits: |
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
| Retirement: |
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.
| Contact Us: |
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
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.