Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Behavioral Health Program Specialist
Apply by: July 27, 2018
This position will remain open until filled
Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive and 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!
The Division of Health Care Management (DHCM) is looking for a highly motivated individual to join our team as a Behavioral Health Program Specialist. The Medical Management unit is in need of a Behavioral Health Program Specialist that understands Medicaid Managed Care and the BH community as well as providers in Arizona. Major duties and responsibilities include but are not limited to:
* Provide technical assistance to internal staff, health plans, providers and other external customers related to clinical issues and programmatic implementation of integrated care services. Provider monitoring and oversight, including but not limited to readiness and operational review efforts, of the Managed Care Organizations.
* Responsible for drafting or revision of policies as well as implementation of policies and MCO adherence to policies.
* Will serve as the Agency’s subject matter expert for Court Ordered Evaluation (COE) and Court Ordered Treatment (COT). Review and assess the COE/COT monthly reports received from the RBHAs. Provide technical assistance to MCOs in regards to COE/COT processes. Support internal monitoring efforts related to COE/COT.
* Lead the High Need/High Cost Program for coordinating care for members with complex needs who receive both physical and BH services.
* Support advanced coordination of care efforts with the Contractors for members with complex needs that are difficult to place. Assist with monitoring of residential treatment and psychiatric inpatient states. Provide oversight of the PSRVB process with the Arizona State Hospital and staff member cases as appropriate.
* Prepares for and participates in the Operational Reviews to include the review of Pre-audit documents and policies, on site audit, formal written documentation of findings, and monitoring the Corrective Action Plans as applicable.
* Manage the authorizations of Out of State Placements and the BH Reinsurance Program. Ensure coordination with appropriate state agencies (e.g. DDD, CMDP).
* Provide oversite of the decertification process for members determined to be Seriously Mentally III (SMI).
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Clinical expertise in the delivery of behavioral health services and programs.
* Monitoring policies and procedures that result in integrated behavioral health services with physical health care services, and/or enhance existing processes to achieve better outcomes.
* Interpreting existing and new rules, laws and agency policy pertaining to the delivery of behavioral health services. Providing effective guidance and technical assistance regarding health care issues and the administration of AHCCCS behavioral health and integrated care programs.
* Communicating effectively with all levels of health care professionals, corporate and agency officers and members.
* In depth knowledge of problem solving and technical writing as well as organizational skills that result in prioritization of multiple tasks.
* Five years clinical and programmatic experience in behavioral health service delivery systems including experience in a public managed care environment.
* Licensed behavioral health professional or a Master’s degree in a behavioral health or health related field is preferred.
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 [email protected] or call 602-542-4700