Arizona Health Care Cost Containment System (AHCCCS)

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HEALTH PROGRAM MANAGER 2(Job Id 49715)

at Arizona Health Care Cost Containment System (AHCCCS)

Posted: 9/20/2019
Job Reference #: 49715
Keywords: operations

Job Description

08/23/2019
CUSTOMER SERVICE 21
PHOENIX 47,476.00-50,865.00

Arizona Health Care Cost Containment System

Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork

Health Program Manager 2

 

OPEN TO AHCCCS EMPLOYEES ONLY

 

First Resume Review: 9/3/2019

 

Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive cost effective health care to Arizonans in need. AHCCCS is nationally acclaimed as a model for other Medicaid programs and recipient of multiple awards for excellence in workplace effectiveness and flexibility.

All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress. Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results. State employees are highly engaged, collaborative and embrace a culture of public service. Visit our careers page to learn more about AHCCCS. Use your skills to benefit others; join the AHCCCS Team!

JOB SUMMARY:

The Division of Member Services (DMS) is looking for a highly motivated individual to join our team as a Health Program Manager 2 in the MA/SP unit. This position manages a staff consisting of nurses, social workers and program services evaluators, customer service representatives, and supervisors who are responsible for determining the eligibility of potential and continuing members and works with the administration of the AHCCCS Long Term Care (ALTCS), Medicare Cost Sharing (MCS) and Medical Assistance - Specialty programs (MA-SP). Major duties and responsibilities include but are not limited to:

* Insuring that uniform interpretations and application of State and Federal laws, agency policies and rules and regulations governing AHCCCS, MCS and MA-SP programs and other related program activities are maintained. 

* Resolving eligibility problems/complaints or refer them to Central Office for resolution if resolution not possible at office.

* Monitoring the quality and timeliness of AHCCCS eligibility determinations.

* Preparing reports and providing recommendations and following up with staff on QC and QA findings. Developing corrective action plans in response to quality findings and the timeliness of eligibility determinations.

* Conducting regular unit meetings to ensure information is given to staff in a timely manner; attending staff meetings. 

* Champion AMS in Eligibility Operations and provide guidance, insight and support to the lag and lead goals at the administrative and operational levels.

KNOWLEDGE, SKILLS AND ABILITIES (KSAs):

* AHCCCS Medical and Financial eligibility and MCS and MA-SP Federal and State rules, regulations, policies and procedures.

* Understanding of Call center operations and CD-10 codes.                                                                                       

* Knowledge of Quality Control (QC) and Quality Assurance (QA) process and how findings relate to the specific functions performed by staff.

* Health-e-Arizona Plus, AHCCCS Prepaid Medical Management Information System (PMMIS), FORTIS, and Rightfax.

SELECTIVE PREFERENCE(S):

* Arizona Driver’s License

BENEFITS   

At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan. Click here to learn more about benefits.

 

Arizona State Government is an EOE/ADA Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 417-4497. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. AHCCCS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.

Click the APPLY NOW button to submit your application.

For technical assistance, email HRIShelpdesk@azdoa.gov or call 602-542-4700.

Application Instructions

Please apply for this position by following the link provided below. A new window will open on your screen and you will be directed to the Arizona Health Care Cost Containment System (AHCCCS) employment website.