Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Health Services Administrative Service Officer
First Resume Review: 02/01/2019
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 Health Services Administrative Service Officer. This position will be responsible for assisting the Clinical Administrator with the leadership of the DHCM Clinical Unit, including assisting the Agency in advancing AHCCCS’s clinical and quality strategies, improving the integrated delivery system and monitoring programmatic and contract functions for both the children’s and adult systems of care. Major duties and responsibilities include but are not limited to:
* Provide technical assistance and oversight of internal staff, health plans, providers and other external customers related to clinical issues and programmatic implementation of integrated care services. Children’s and Adult Systems of Care, including but not limited to Crisis Services and Mental Health Parity.
* Manage review of authorizations for Out of State Placement, the Behavioral Health Reinsurance program and Clinical Decertification for member cases determined to be Seriously Mentally Ill (SMI).
* Provide oversight to the PSRB functions and serve as the primary lead for the AMPM Behavioral Health policies.
* Directly supervise Children’s System of Care Staff and provide management assistance to the Clinical Administrator for all Clinical Unit teams as needed.
* Lead the High Need/High cost Program for coordinating care for members with complex needs who receive both physical and BH services, participate in Case Resolution and other member staffing reviews as needed.
* Review and assess the Court Ordered Evaluation/Court Ordered Treatment monthly reports received from the Managed Care Organizations (MCO’s), and provide recommendations for improvement where needed.
* Prepares for and participates in the Operational Reviews to include the review of Pre-audit documents and policies, onsite audit, formal written documentation of findings and monitoring the Corrective Action Plans as applicable.
* Attends Clinical Oversight Committee, Quarterly Medical Director Meetings, Quarterly MM Meetings, Quarterly QM Meetings, Quarterly Community Quality meetings, monthly Opportunities and Trends meeting, agency meetings and other ad hoc meetings as necessary.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Clinical expertise in the delivery of behavioral health services and programs including SMI rules.
* Knowledge of the Arizona Public Behavioral Health system including AHCCCS/Administrative policies and procedures.
* Principles and practices of program planning, assessment skills, Child Family Team (CFT) and Adult Recovery Team (ART) models and mechanisms of managed prepaid health care systems, preventative health practices, organization of health care systems and current trends that affect the system and research methodology and process.
* 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.
* Analytically reviewing and evaluating program activities. Analyzing problems and make recommendations for improvements.
* Understand and communicate data/health analytics.
* Produce effective written communication, produce work products with limited supervision and Multi-task in a fast paced environment.
* Five years clinical and programmatic experience in behavioral health service delivery systems including experience in a public managed care environment.
* A licensed behavioral health professional.
* A licensed clinical social worker (LCSW) or
* Registered Nurse or Nurse Practitioner with Psychiatric-Mental Health specialty or a Masters degree in a behavioral health or health related field.
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.