Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Nurse Care Coordinator
First Review 01/29/2019
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 Fee for Service Management (DFSM) is looking for a highly motivated individual to join our team as a Nurse Care Coordinator. Responsible for care coordination of medical and/or behavioral health care for tribal members with unusual and complex cases. Major duties and responsibilities include but are not limited to:
* Devises and reviews data reports to identify high need/high cost members for care coordination and leads regularly scheduled clinical discussions with IHS/638 Providers and/or behavioral health system/providers regarding high utilization and trends, and complex cases.
* Participates in the Care Management Systems Unit (CMSU) care coordination efforts, such as infrastructure development, review of high need/high cost evaluation to inform clinical decisions, working with other AHCCCS divisions for member care, including pharmacy, member services, quality management, etc.
* Participates in process improvement and other special projects, work groups and committees to improve the efficiency of care coordination, utilization management and other CMSU functions.
* Participates in outreach efforts with IHS/638 Facilities, including the American Indian Medical Homes, along with other Care Coordination team members.
* Develops reporting/tracking/trending to present to DFSM and agency management.
* Conducts contact work with the tribes to establish rapport and close collaboration with providers and facilities. Serves as back up resources to all clinical functions in CMSU.
* Other duties as assigned as related to the position (typically 5% - 10%).
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Holds a License as a Registered Nurse, Physician’s Assistant or Nurse Practitioner.
* Knowledge of case management concept, principles, and strategies.
* Problem solving-identification, evaluation and initiation of appropriate action, nursing and case management assessment.
* Strong ability to collaborate with others for a mutually beneficial outcome.
* Principles of Medical Nursing Management and assessment.
* Excellent communication, verbal and written with FFS Providers.
* Interpret clinical information and assess implications for treatment.
* Drive long distances, when required.
* Ideal candidate will be a Certified Case Manager.
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.