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Division of Managed Care Services (DMCS)
All AHCCCS Employees must reside within the state of Arizona.
The Case Management Unit is a critical component of the ALTCS Program. Effective program development, management and oversight of ALTCS CM program has a huge impact on how well members are served by the ALTCS Contractors. This position will function as the manager for the CM program within the Division of Health Care Services. As a major function of this role, oversight and monitoring of the ALTCS Case Management Program is an essential part of ensuring quality care and appropriate services to our ALTCS members.
Major duties and responsibilities include but are not limited to:
• Ensure ongoing case management compliance by the ALTCS Program contractors (case management service reviews, data reports, performance reports, operational reviews, and correction actions). Maintains regulatory active oversight of the ALTCS Program contractors, Inter-Governmental Agreements (IGAs) for DDD members. Collaborates with DFSM on the ALTCS Tribal Program.
• Develops programs, initiatives, processes, and improvements/maintains quality care coordination, case management, behavioral health services, home and community based services, disease management and healthcare education for ALTCS members.
• Maintain accurate and up to date case management policies. This includes collaboration with internal and external teams to develop, maintain and monitor the policies for an effective program.
• Provide technical assistance and ongoing training to ALTCS Program contractors.
• Responsible for specialized programs, including but not limited to the Federally mandated Pre-Admission Screen and Annual Resident Review (PASRR).
• Supervises, directs activities, and monitors/evaluates staff.
• In collaboration with the AHCCCS Information Services Division maintains the “CATS” system so that case management information is collected from the contractors and that accurate reports can be produced.
• Collaborate with internal and external stakeholders for the ALTCS program.
Knowledge:
• Methods to develop, administer and oversee the ALTCS case management program
• The population served by the ALTCS program (elderly, physically disabled, and developmentally disabled and their service needs)
• Medicaid and Medicare Federal Regulations, State Statute and Rule and policies applicable to the ALTCS and other AHCCCS programs, managed care concepts and practices
• How specific agencies function and inter-relate
• ALTCS and AHCCCS program design and implementation, including case management function and responsibilities, provider network and funding sources
• AHCCCS computer systems
• Community resources relative to providers of service to AHCCCS and ALTCS clients, basic knowledge of Third Party Liability process
• Native American Tribes/programs and ALTCS policy relative to Inter-Governmental Agreements and related policies
• Techniques to select a particular approach to analyze, develop, or implement a policy
• Techniques to select a particular approach to design and administer an operational analysis method
• PASRR
• Decision-making techniques of setting ALTCS case management priorities
Skills:
• Analysis, evaluation and resolution of complex problems
• Excellent interpersonal skills with individuals as well as large groups
• Effectively collaborating with people in position on all levels.
• Effectively leading and/or facilitating a team of professionals from within and/or outside the agency including public speaking
• Producing effective written communication
• Conflict research and resolution
• Multi-tasking in a fast paced environment
• Producing work products with limited supervision
• Project management to meet goals and deadlines
• Computer software (e.g., word processing, spreadsheets, databases)
Abilities:
• Represent AHCCCS effectively both internally and externally
• Work independently and make decisions within defined scope
• Active contributor in team and stakeholder meetings
Minimum:
• Four years professional experience related to health program appropriate to the assignment which includes experience in interviews and investigations AND Two plus years managerial experience.
Preferred:
• Prefer a Masters in Social Work, Nursing, Public Administration, Health Administration, or Business Administration. A Master's degree may substitute for one year of the required work experience.
• Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees.
• 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.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.
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 (pilot program).
• 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 program here. 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.
ARIZONA MANAGEMENT SYSTEM (AMS)
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.
The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.
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
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