Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Finance and Reinsurance Supervisor
First Resume Review: 11/30/2018
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 Finance and Reinsurance Supervisor. Under the direction of the Finance and Program Monitor, this position is responsible for supervising the Reinsurance Unit staff, as well as, oversight of the payments and auditing of reinsurance cases and transplants. This position also assists the Finance Unit with financial reports. The position requires critical thinking skills and financial analysis. Major duties and responsibilities include but are not limited to:
* Review program/policy changes and contracts to make recommendations to management relating to required changes in processes and to develop and revise/maintain a series of guides, manuals and forms for external contractors. In addition, oversee and develop internal processes, documentation and systems related to new contract-years.
* Supervise three program compliance auditors. Develop audit plans and work process for their timely adjudication/audit of cases, including analyze and evaluate outcomes.
* Conduct Reinsurance training for all AHCCCS Contractors including development of a quarterly workshop. Provide technical assistance both written and verbal for all contractors. Attend meetings for AHCCCS Health Plans when necessary.
* Assist Finance Department with review of health plan Quarterly and Annual Financial Reporting and with the completion and/or quality control review of various reports relating to health plan financial results.
* Plan and manage the Reinsurance portion of the Operational Review for all AHCCCS Contractors including development of standards and audit tools/plans and review/acceptance of Contractors' corrective action plans (i.e., Corrective Action Plans, Contractor issues and Special Reports).
* Coordinate the federal audit of reinsurance payments, including development of written/verbal challenges and implementation of corrective actions, if necessary, as well as, completion and quality control review of various financial reports.
* Work with AHCCCS Information Services Division (ISD) for application and implementation of the AHCCCS Reinsurance PMMIS-EXTRA Database. Recommend necessary system changes/enhancements to ensure correct case creation and reimbursement per contractual guidelines. Test proposed updates to the Reinsurance database. Review all changes to the AHCCCS Encounter database for impacts to the Reinsurance database.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Demonstrated knowledge with health care claims/encounter coding as related to current procedural terminology.
* Demonstrated knowledge with the principles of accounting, financial reporting, auditing and financial analysis.
* Effective interpersonal and leadership skills; above average written and oral communication skills; and public speaking.
* Ability to interpret federal and state mandates to assess the potential impact on AHCCCS policies, rules and programs as assigned.
* Ability to prioritize work processes of self and others and shift priorities/tasks and make decisions in a fast-paced environment.
* Skilled in the techniques, tools, procedures and methods to monitor the Contractors’ claims/encounter systems.
* Above average Excel and Word skills.
* Two to three years of experience working in a managed care environment.
* Bachelor’s Degree in Accounting, Business Administration or related field of study.
* Certified Internal Auditor or MBA degree.
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.
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For technical assistance, email HRIShelpdesk@azdoa.gov or call 602-542-4700.