Clinical Care Specialist

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profile Job Location:

Phoenix, NM - USA

profile Monthly Salary: Not Disclosed
Posted on: 4 hours ago
Vacancies: 1 Vacancy

Job Summary

DEPARTMENT OF CHILD SAFETY

The Arizona Department of Child Safety (DCS) is a social and human services agency whose mission is to successfully partner with families caregivers and the community to strengthen families ensure safety and achieve permanency for all Arizonas children through prevention services and support.

Clinical Care Specialist

Job Location:

HEALTH SERVICES
3003 N Central Ave Phoenix AZ 85012

Posting Details:

Salary: $24.8232 HRLY/$51632.26 Salary

Grade: 19

Closing Date: Until filled

Job Summary:

This position is responsible for providing care management and and clinical care coordination for Comprehensive Medical and Dental Program (CMDP) members. The Care Coordinator works with medical professionals caregivers clinic/hospital/specialty providers and community resources in a team approach to promote timely access to appropriate health care services for CMDP members.

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.

Job Duties:
  • Provides care management for members entering into or transitioning from Medicaid healthcare plans; prepares and process Enrollment Transition Information (ETI) documentation; writes and dictates medical case notes histories and narratives for use by CMDP clinical staff and DCS Specialists.
  • Processes prior authorization requests and completes Notice of Actions (NOAs) for medical dental and orthodontia denials.
  • Verifies and manages all incoming emergency room utilization and hospital readmissions; research and record non routine or unusual emergency visits; prepares and presents data on inpatient cases and multiple ER visits.
  • Provides outreach to member caregivers adoptive or foster parents DCS Specialists and other agency representatives to initiate member referrals for ALTCS services; provides care management and performs outreach for CMDP members who are identified as pregnant.
  • Manages and prepares requests for medical records; processes immunization record reports; presents cases to clinical staff for review and decision.
  • Answers incoming calls; provides customer service regarding general medical and dental inquires; interprets and implements CMDP policies and procedures.
  • Serves on CMDP committees as assigned; provides assistance and trains other CMDP employees.
  • Other duties as assigned as related to the position.
Knowledge Skills & Abilities (KSAs):

Knowledge of:

  • Department of Child Safety (DCS) policies procedures
  • Current state federal and local laws governing Arizona Health Care Cost Containment System (AHCCCS) and Medicaid health plan operations
  • Healthcare administration as it relates to children in foster care
  • Customer service principles and practices
  • Microsoft applications
  • Pediatric medical terminology

Skills in:

  • Written and verbal communication
  • Establishing and maintaining interpersonal relationships
  • Comprehending and interpreting principles and practices of health plan operations
  • Problem solving
  • Navigating within computer applications
  • Time management and multi- tasking

Ability to:

  • Maintain up to date knowledge of agency and department policies and procedures
  • Understand importance of and respect for the confidentiality of member information in accordance with applicable standards and regulations
  • Work under pressure in a high paced environment
Selective Preference(s):

Formal training and/or certification in medical and/or dental coding and terminology.

Pre-Employment Requirements:

N/A

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:

The State of Arizona provides an excellent comprehensive benefits package including:
Affordable medical dental life and short-term disability insurance plans
Top-ranked retirement and long-term disability plans
10 paid holidays per year
Vacation time accrued at 4:00 hours bi-weekly for the first 3 years
Sick time accrued at 3:42 hours bi-weekly
Deferred compensation plan
Wellness plans

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:

Positions in this classification participate in the Arizona State Retirement System (ASRS). Enrollment eligibility will become effective after 27 weeks of employment.

Contact Us:

Required Experience:

IC

DEPARTMENT OF CHILD SAFETYThe Arizona Department of Child Safety (DCS) is a social and human services agency whose mission is to successfully partner with families caregivers and the community to strengthen families ensure safety and achieve permanency for all Arizonas children through prevention se...
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Key Skills

  • Sales Experience
  • Crane
  • Customer Service
  • Communication skills
  • Heavy Equipment Operation
  • Microsoft Word
  • Case Management
  • OSHA
  • Team Management
  • Catheterization
  • Microsoft Outlook Calendar
  • EHS

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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