Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Management Analyst II
First Resume Review: 02/21/2020
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 II. This position will be responsible for analyzing and auditing medical encounter data studies, operational reviews, ad hocs, medical encounter logs, validate desktop procedures and technical documents. This position will participate in development and facilitating medical encounter/data validation studies related to training for external and internal stakeholders. Major duties and responsibilities include but are not limited to:
* Participate in the development of medical data collection and review, and timely completion of medical data validation studies, operations reviews, quarterly encounter logs and ad hoc audits.
* Design, formulate and evaluate spreadsheets used to analyze and track encounter quality.
* Recommend changes as to the workability and efficiency of health plan encounter data reporting practices and procedures. Evaluate corrective actions and advise management on possible courses of action.
* Respond to technical inquiries from Contractor personnel.
* Participate in the development and facilitation of encounter/data validation related training workshops for external and internal stakeholders
* Participate in the development and maintenance of data validation desktop procedures and technical documents.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Understanding of contractual requirements, policy and procedures related to the submission and oversight of encounter submissions.
* Professional standards, methods, forms and procedures for the reporting of medical claims/encounter information.
* Versed in ICD-9, ICD-10, CPT/HCPCS coding and National Drug Codes.
* Working in a managed care environment, Word, Access, Excel, Power-point and Google.
* Oral and written communication skills, including grammar
* Analyze complex problems and draw logical conclusions based in information from several sources.
* Communicate effectively when interacting with persons in a variety of settings, including personnel from Contractors.
* 3-4 years experience in medical claims processing or billing, OR
* 1-2 year Community College/Vocational School in nursing or medical record technology and 2 years experience performing operation or program specific analysis; OR
* Certification as Professional Medical Coder supported by AMA, HCFA, National CPT Advisory Committee & 1 year experience performing operational or program specific analyses.
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.