AHCCCS

Address:  801 E. Jefferson Street, Phoenix, AZ 85034

Must reside in the State of Arizona.

Salary:  $77,958 - $81,855

Grade: 28

Closing Date: Open Until Filled

This position is eligible for full-time remote work (including virtual office arrangement in Arizona).

A career in public service awaits you. COME JOIN OUR TEAM!

A great benefit of working for the State of Arizona is a fantastic work/life balance. State employees enjoy challenging work, popular remote work options, comprehensive health and wellness benefits, and career growth opportunities.

We are searching for someone to join our Program and Integrity team who will manage OIG reporting, allegations of fraud and work alongside investigators in assisting them to build strong court cases. You may also have the chance to represent AHCCCS in the data review processes during legal or civil proceedings, with attorneys, and law enforcement. If you enjoy research, investigating fraud, waste and abuse, compiling data, have experience with SQL, dashboard development Power BI, Cognos, and reporting -- this could be the job for you. Come Work With Us! 

What You'll Do:

This role manages the support of reporting and data analysis for fraud investigations within the AHCCCS ISD division on behalf of the OIG division. Responsibilities include managing the production of ad-hoc and standard reports, pulling random data samples, extracting files, creating and managing dashboards, and assisting in audits and interagency information requests.

The supervisor oversees report development and approves comprehensive written analysis reports for leadership, legal and law enforcement agencies. Additionally, this position advises senior management on administrative and data analysis issues related to healthcare fraud and program mismanagement, interprets policies and procedures and CMS alerts, and effectively communicates with stakeholders to design analytical tools and analyses. The role may also represent AHCCCS in data review processes during legal or civil proceedings, with attorneys, and law enforcement.

Major duties and responsibilities include but are not limited to:
• Oversee the development, maintenance, and enhancement of reporting and dashboards within the AHCCCS ISD division on behalf of the OIG division. Manage Federal and State reporting requirements, including grants. Assign work and monitor the progress of assigned data analysis requests that include ad- hoc reports, data samplings, audits and interagency requests for information.
• Manage project timelines and communication with staff, stakeholders, and leadership for reporting and dashboard due dates. Proactively engage with organizational leadership to allocate staff and resources effectively. Lead projects, manage staff workloads, product upgrades, and implementations while ensuring on-time and on-budget delivery.
• Facilitate and participate in meetings with internal and external organizations. Collaborate with Executive leadership from AHCCCS, other State agencies, and business partners to review reports and dashboards. Manage the collection and dissemination of business requirement planning, analysis, logical and physical design, implementation and maintenance of reporting, analytical tools, and dashboards.
• Manage relationships with contracted organizations, such as vendors and business partners, to facilitate reporting and dashboard development and software and application development tools. This role is responsible for ensuring all technical and reporting standards and data quality assurance processes are met before releasing reports.
• Manage and direct subordinate staff (work assignments, setting priorities, hiring, discipline, provide training, approving leave requests, and preparing evaluations). Develop and adhere to project timelines and ensure that Agency and OIG policies and procedures are met.
• Maintain liaison with the appropriate health plans and Agency offices in the coordination of audit findings.
• Manage training for reporting tools such as Power BI and Cognos. Participate in data stewardship and data governance activities to ensure data integrity and compliance

Knowledge:
• Broad & generally deep understanding of all facets of management & leadership, as well as a vision for the specific business program/function being managed
• Business Intelligence, Data Analytics, and Enterprise Reporting
• Structure Query Language (SQL) and data management techniques, including relational database structures
• Project Management Methodologies
• AI, LLM, and predictive modeling techniques
• The Software Development Life Cycle (SDLC), ITIL, COBIT, and its relationship to reporting, data visualization, analytical tools, and dashboard development
• AHCCCS claims & encounter data including data definitions & processing schedules
• AHCCCS methodologies and tools including but not limited to Cognos and Power BI
• AHCCCS delivery system including Managed care & Fee-for-Service, Federal and state laws, rules, regulations, and policies related to the Medicaid program
• AHCCCS policies and procedures & interrelationships between various internal & external organizational functions

Skills:
• Verbal and written communications
• Applying the methods and techniques of performance/compliance auditing
• Applying the methods and techniques of fraud auditing and fraud investigations
• Interpreting and applying federal and state laws, rules, regulations, and procedures
• Interpreting AHCCCS contracts, subcontracts, policies and procedures
• Computing, summarizing, and aggregating qualitative and quantitative data in an accurate and timely manner
• Organizing, documenting, and preparing work papers, which includes use of available software
• Written and verbal communication
• Working within a team environment
• Organizing, facilitating and coaching a work unit and project team
• Motivation of subordinates and interpersonal relations

Abilities:
• Balance, prioritize & organize multiple tasks
• Effectively manage due dates and communicate to stakeholders
• Work collaboratively in teams & across organizations
• Synthesize feedback & adjust plans accordingly
• Build strong relationships inside & outside the organization
• Work collaboratively in teams & across organizations
• Manage medium to large teams
• Evaluate & test emerging technologies
• Apply creative solutions to business problems to ensure business needs are most effectively met
• Understand & anticipate needs & priorities of both internal & external customers
• Develop, train, and perform relational database tasks such as data pulls, report and dashboard creation
• Effectively manage teams that can comply with data quality and data management techniques
• Effectively manage a team that produces reports, extract files, creates and manages dashboards, and performs impact analyses that inform the agency’s decision-making and policy development

Minimum:
• Bachelor's degree in Information Technology, Computer Science, Statistics, Economics or health care related field plus 3 years of business analysis experience to include 2 - 3 years experience with data warehouses and business intelligence tools and 1 year of experience in Medicaid and/or Medicare (or equivalent experience).

Preferred:
• Experience preparing/presenting dashboards and data using a data visualization tool such as PowerBI. Experience clearly explaining complex methodologies and present findings and recommendations to both technical and non-technical audiences.

• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s 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 R2-10-207.12.) 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: Driver’s 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.

 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 careers@azahcccs.gov.
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.