Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Sr. QA Analyst/ QA Manager
Apply By: 02/09/2020
Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive 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 Member and Provider Services (DMPS) is looking for a highly motivated individual to join our team as a Senior QA Analyst/Quality Manager in the office of Eligibility Coordination & Oversight (OECO). This position oversees all PAS (medical) QA and financial QA positions. This position provides guidance regarding quality issues and questions. The incumbent will ensure all processes and procedures are regularly reviewed and updates are made to result in consistent, error-free, always improving client interactions. Major duties and responsibilities include but are not limited to:
* Managing and developing financial and medical Quality Assurance supervisors and staff who are responsible for quality assurance reviews, outcome analysis, deficiency challenges, quality clarifications, and updates to quality assurance process and procedures, results tools and supporting materials.
* Ensures uniform interpretations and application of State and Federal laws, agency policies and rules and regulations governing Medicaid and KidsCare and other related program activities are maintained.
* Monitoring new rules and regulations to determine impact on QA operations and make plans of necessary changes to the quality review process.
* Participating in leadership meetings to include CORE Managers, PAS Steering committee, OECO Leadership and others as appropriate. Participating in DMPS and agency policy and systems development work groups and process improvement teams as appropriate.
* Champion AMS and provide guidance, insight and support to the lag and lead goals at the administrative and operational levels. Lead Root Problem Solving activities. Mentor QA staff to develop an operationally efficient and highly performing engaged workforce.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Demonstrated ability to lead, coach and direct supervisors and front line employees typically acquired through 3 years supervisory experience.
* Knowledge of Quality Control (QC) and Quality Assurance (QA) processes and how findings relate to the specific functions performed by staff.
* Skilled in data collection and root cause analysis to effectively improve processes and procedures.
* Ability to effectively communicate professionally both orally and in writing, on a one-on-one basis as well as in larger group settings.
* Knowledge of Federal and State laws and regulations governing Medicaid to included ALTCS (Arizona Long Term Care System), MSP (Medicare Savings Program) and SSI MAO (Supplemental Security Income Medical Assistance Only) programs along with KidsCare is preferred.
* Experience with Systems: Health-e-Arizona Plus, AHCCCS Prepaid Medical Management Information System (PMMIS), FORTIS, and Rightfax is preferred, but not required.
* Bachelor’s degree or Arizona RN license preferred, but not required.
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.