Salary: $71032

Grade: 23

The Division of Managed Care (DMC) is looking for a highly motivated individual to join our team as a Maternal Child Health (MCH) Early and Periodic Screening Diagnostic and Treatment (EPSDT) Coordinator. Under the leadership of the MCH EPSDT Program Manager this position provides oversight of the EPSDT womens preventive health family planning and maternity care services within AHCCCSs statewide managed care and fee for-service programs. This role ensures services that support pregnant and postpartum members; infants and children are delivered in compliance with state and federal requirements. This position is responsible for quality improvement activities validating deliverables identifying gaps and recommending strategies to improve performance.

Major duties and responsibilities include but are not limited to:
Oversight and monitoring of EPSDT womens preventive health family planning and maternity care programs to ensure state and federal requirements are met.
Participate in operational reviews administrative reviews technical assistance and focused studies/reviews to ensure compliance with contractual and policy requirements for all lines of business. Follow-up on written reports corrective action plans and other compliance actions as appropriate.
Represent the MCH EPSDT Unit in the development and revision of contracts amendments and policy. This position may participate in work groups steering teams and scoring teams as needed and requested by the agency.
Provide education and technical assistance to internal and external stakeholders including Contractors and FFS providers as appropriate regarding covered services and contractual or policy requirements accurately and consistently to improve compliance with AHCCCS requirements and improve EPSDT and maternal child health services to AHCCCS members. Includes identification research and resolution of issues as needed.
Collaborate with other AHCCCS units and state and local health and social service agencies including ADHS DES/DDD DCS Head Start Vaccines for Children (VFC) childhood lead prevention program etc. as well as community and private health care providers.
Coordinate and complete tracking evaluation and responses to Contractor deliverables such as annual program plans and member materials to assure MCH EPSDT components are thoroughly addressed and align with policies.
Lead special projects and reviews to ensure completion within the designated timelines and alignment with current recommendations. Provide ongoing updates to Management.

Knowledge:
State and Federal rules regulations policies and procedures governing Title XIX Title XXI Managed Care and LTC and Tribal lines of business
Medical/nursing practice medical case management protocols quality management and utilization review protocols as related to the all populations including maternal and child health services womens preventive health family planning services and supplies EPSDT acute LTC chronic long-term elderly and physically disabled developmentally disabled behavioral/mental health children in the foster care system and Tribal lines of business
Current quality improvement and health care theories and practices
Background in and knowledge of quality management principles and accreditation bodies review processes

Skills:
Organizational skills for setting priorities workload and record keeping
Project management to meet goals and deadlines
Public speaking and delivering presentations or technical assistance to internal and external stakeholders
Written communication and correspondence with internal and external stakeholders
Problem-solving techniques evaluation and initiation of appropriate action
Research and analytical skills
Interpret and apply rules regulations and policies to MCH EPSDT program operations and oversight activities
Interpret clinical information

Abilities:
Develop implement and review case management and utilization review systems and the ability to offer technical assistance to Acute LTC Sister Agency and/or tribal Contractors
Manage multiple priorities effectively
Lead special projects
Collaborate with internal and external stakeholders
Identify gaps and recommend solutions

Minimum:
Possession of a current license to practice as a registered nurse in the State of Arizona and three (3) years of relevant healthcare experience.

Preferred:
At least one year of experience working in Medicaid managed care case management or health plan administration.

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.