Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Management Analyst 2
First Resume Review: 10/15/2019
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 Management Analyst 2. This position will serve as the encounter subject matter expert for AHCCCS and the main encounter contact and technical liaison for the AHCCCS Contractors. The position helps AHCCCS collect complete and accurate encounter data that is used to set Contractor capitation rates; develop fee-for-service rates; calculate and pay supplemental rates; calculate disproportionate share hospital rates; access quality of care, outcome and disease management; conduct utilization review and reporting; perform fraud and abuse analysis and reporting; produce Federal reports; conduct medical audits; and general information management. Major duties and responsibilities include but are not limited to:
* Provide technical assistance to the Contractors on encounter data submission and error correction. Respond to technical inquiries from internal and external customers.
* Monitor encounter submission identifying trends, potential risk, areas on non-compliance and provide detailed analysis following the system cycles. Include the review of Contractors contract deliverables.
* Plan, organize and conduct pending encounter research and analysis.
* Provide detailed analysis and administrative assistance to the Encounter Unit, Encounter Manager and the Contractors.
* Recommend changes as to workability and efficiency of Contractor encounter data reporting practices and procedures. Conduct follow-up and evaluation of recommendations and advise management on possible courses of action.
* Lead the development and facilitation of encounter related training workshops for external and internal stakeholders.
* Participate in Operational Reviews of the Contractors and the preparation of Contractor Encounter meetings (Quarterly, Ad Hoc).
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Knowledge of Claims/Encounter processing, concepts and industry practices
* Knowledge of Medicaid/Medicare programs and services
* Demonstrated knowledge of research methodologies
* Versed in ICD-9, ICD-10, CPT/HCPCS coding and National Drug Codes
* Thorough knowledge of computerized Prepaid Medicaid Management Information System (PMMIS) and the Transaction Insight Portal
* Ability to analyze complex problems and draw logical conclusions based in information from several sources, including plan surveys, and discussions with technical personnel;
* Strong ability to communicate effectively when interacting with persons in a variety of settings, including personnel from Contractors
* At least one year experience working in a managed care environment
* Three years responsible administrative experience or a Bachelor’s degree in business, health administration or related field and two years responsible administrative experience in any or all of the following areas: claims processing, encounters and health care operations
* Excellent computer skills including Word, Access, Excel, PowerPoint and Google
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.