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OOD Division Overview
The Arizona Health Care Cost Containment System (AHCCCS) is led by the Director who is appointed by the Governor. The Director has overall responsibility for ensuring that the Agency meets the goals established in the Agency Strategic Plan and insures that the organization has the administrative infrastructure to meet the needs of the Agency.
The Director provides strategic direction and manages high level, critical issues for the Agency at the local, state and federal levels. Through the Executive Staff, the Director manages all aspects of the Agency's business processes and is responsible for implementing and developing administrative policies and procedures to support the delivery of health care services for over one million AHCCCS members.
The Deputy Director assumes responsibilities of the Director in his absence or discretion and represents the Agency among a wide range of Agency stakeholders. The Deputy Director also oversees the majority of the Agency operations and is responsible for providing counsel and recommendations to the Director on Agency issues and programs.
In addition to the Director and Deputy Director, the Chief Medical Officer (CMO) oversees the quality and delivery of health care services provided by AHCCCS. The CMO approves the AHCCCS medical policies and assures the appropriate evaluation of contract compliance.
The Office of the Director (OOD) consists of: the Office of Intergovernmental Relations (OIR); the Office of Business Intelligence (OBI); the Dental Director; the Pharmacy Director; the HIT Coordinator, and Project Management/Payment Modernization (PMPM).
Office of Intergovernmental Relations (OIR)
OIR is responsible for the development of AHCCCS state and federal legislative initiatives and legislation. OIR functions include but are not limited to: serves as the principal liaison and point of contact with the Centers for Medicare and Medicaid Services (CMS) on Title XIX and XXI issues; maintains regular communication with the Office of the Governor and serves as an advisor to the Director and Governor's Office on issues related to health care policy.
Office of Business Intelligence (OBI)
OBI manages the AHCCCS Data Warehouse, the repository for the analytical data used in the management and development of policy, quality monitoring, and public reporting for the agency. OBI's Technical Team builds and manages the data warehouse and provides training and support to users throughout the agency. OBI's Data Analytics Team provides custom data analysis and reporting to the agency as well as user support services and analysis for special projects.
Dental Program Director
Oversees the quality and delivery of oral health care services provided by AHCCCS health plans and contractors or directly to fee-for-service members; reviews fee for service prior authorizations and dental claims, when appropriate; reviews and suggests modification of AHCCCS dental policies; and assists in evaluating and resolving member and provider grievance.
Oversight and monitoring responsibilities of the AHCCCS fee-for-services pharmacy program, Agency participation in the Medicaid Drug Rebate Program and oversight of certain Contractor pharmacy activities.
The HIT Coordinator serves as the Medicaid HIT Coordinator and the State HIT Coordinator. The Medicaid HIT Coordinator serves as a single point of contact within the agency and represents the agency in state level strategic discussions between internal and external stakeholders. In the role of State HIT Coordinator, acts as the key advisor on all issues related to electronic health information technology and exchange.
Project Management/Payment Modernization
This unit directs and supervises agency projects from beginning to end providing leadership, direction and oversight by initiating, defining, coordinating and monitoring projects, which requires input and verification of information from multiple divisions within the agency as well as external agencies and stakeholders. The unit also helps manage the payment modernization strategies that are currently being pursued by AHCCCS to better align incentives within the health care delivery system.