DEPARTMENT OF ECONOMIC SECURITYYour Partner For A Stronger Arizona. |
| Job Location: |
| Posting Details: |
| 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 Compliance Officer. 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 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:
Implementing the Compliance work plan. Conducting complex internal compliance investigations and audits. Developing implementing and monitoring corrective action plans. Resolving non-compliance. Facilitating root cause analysis for non-compliance and high-risk conditions. Internal oversight of organizational compliance with Program Integrity and preparation and execution of regulatory audits.
Developing and maintaining compliance data bases tracking tools and auditing tools to enhance ability for data mining. Identifying trends creating reports from data analysis to monitor and evaluate compliance in related projects and programs. Providing ongoing resources and advising the team and management about the Compliance issues. Supporting the activities of the Compliance Committee.
Developing educational materials related to Corporate Compliance Medicaid Fraud Waste & Abuse and Standards of Conduct. Interpreting of internal monitoring and compliance metrics. Guides managements consistent application of the Compliance Program at the service level. Directs actions to improve gaps in contractual and regulatory compliance.
Completing external audits to determine compliance with Federal State and healthcare billing requirements. Evaluates the adequacy and effectiveness of internal and external operational controls. Implementation and monitoring of DDD District and AdSS corrective action plans. Provides technical assistance to DDD and AdSS in improving compliance with DDD/ AHCCCS/ CMS/CFR standards.
Processing allegations of fraud waste and abuse and misconduct for non-compliance or regulatory violations including anonymous calls and calls received on confidential hotline.
| Knowledge Skills & Abilities (KSAs): |
Knowledge in:
Fraud waste and abuse laws and regulations including the False Claims Act Deficit Reduction Act requirements Anti-Kickback statute and Stark law provisions.
Healthcare compliance audit methodologies principles and claims processing.
DDD rules policies procedures and guidelines.
Organizational relationship of the DDD to members and families AdSS subcontracted provider network and service provision.
Skills In:
Quantitative analyses using Medicaid enrollment claims and program data to support program monitoring improvement or evaluation of compliance with contractual requirements state and federal rules and regulations.
Advanced computer skills to include high proficiency in all MS Office applications (Word Excel Access PowerPoint Project Plan OneNote etc.).
Project management Interpersonal skills and leadership.
Written and verbal communication skills; editing documents for professional appearance.
Ability to:
Develop automated auditing tools data bases and tracking tools.
Examine claims and calculate payments based on contract terms to determine accuracy of payment through use of various reports and supporting documentation.
Initiate and follow-through on projects with little supervision or guidance.
Assist in the development and revision of policies and procedures; understand and interpret policies procedures and regulations; edit and coordinate editing of policies.
| Selective Preference(s): |
The ideal candidate for this position will have:
Bachelors Degree in Public Health Health Care Administration business analysis or administration or closely related field OR minimum five years of equivalent healthcare compliance experience to include data mining and analytics; minimum three yeas of experience with internal and external auditing monitoring healthcare claims processing corrective action planning project management and process improvement.
| Pre-Employment 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).
| 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
Paid vacation and sick time
Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child.
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 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 Wendy Browning 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:
Unclear Seniority
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.