Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Nurse Case Manager
Apply by 02/19/2020
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 Fee for Service Management (DFSM) is looking for a highly motivated individual to join our team as a Nurse Case Manager. This position, working out of the Flagstaff area, is responsible for understanding the needs of members with physical, behavioral and CRS conditions & other special healthcare needs. Coordination of medical and/or behavioral health care, including specialized transports for tribal members with unusual or complex cases, discharge planning and coordination of continued care. In addition will coordinate services and authorizations for members transitioning from the AHCCCS Health Plan to American Indian Health Program (AIHP). Major duties and responsibilities include but are not limited to:
* Coordinate medical and behavioral health care and specialized transports for members with unusual and complex cases, CRS conditions and other special health care needs, discharge planning and coordination of continued care, i.e., arranging for DME, specialty care, SNF, CRS referrals, or home health.
* Conduct contact work with the tribes, TRBHAs, and IHS/638 medical homes to establish rapport and close collaboration with community providers and facilities. Conduct contact work with other Fee-for-Service providers for care coordination.
* Coordinate services and authorizations for members transitioning from AHCCCS Health Plans to the American Indian Health Program. This will include contact work with FFS Providers who serve American Indians to encourage that members be seen in tribal or IHS facilities in their home communities.
* Coordinate medical care for transplants in conjunction with the AHCCCS Division of Healthcare Management, including specialized transportation, meals and lodging.
* Serve as back up resource to all clinical functions in the Care Management Systems Unit. Participate in process improvement and other special projects, workgroups and committees to improve the efficiency of care coordination, utilization management and other CMSU, Clinical Operations Unit functions.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Holds a License as a Registered Nurse or Nurse Practitioner
* Case management concepts, principles, and strategies.
* Principles and Medical Nursing Management and assessment.
* Interpret clinical information and assess implications for treatment.
* Strong interpersonal skills in working with socioeconomic backgrounds.
* Problem solving-identification; evaluation and initiation of appropriate action, nursing and case management assessment.
* ICD-10 diagnosis coding; CPT procedure coding.
* Ability to learn AHCCCS and AL TCS program design and implementation, case management functions and responsibilities, provider network, and funding source.
* Ideal candidate would be a Certified Case Manager, and must have (3) years of Relevant experience
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.