Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Quality Management Clinical Analyst
apply by: july 27, 2018
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 Quality Management Clinical Analyst. This position is responsible for administrative functions relating to the processing, tracking and trending of Quality of Care (QOC) concerns. As a Quality Management Clinical Analyst, the chosen candidate will provide support to the QM coordinators, Lead QM Coordinator and the QM Manager including opening of QOC cases, documentation of case work in the QOC database. Major duties and responsibilities include but are not limited to:
* QOC case openings; includes assessment of potential QOC notifications for allegation determination, documentation in appropriate databases, creation of opening letters, documentation to case tracking logs, and weekly monitoring of QM Coordinator documentation to complete opening process.
* Data analysis for Huddle Board metrics, support/maintenance for SharePoint, documentation of central spreadsheet for case assignments, and other analytical/administrative support as identified such as development of job aids.
* Tracking of systemic QOCs and trending of case time lines, volumes, etc.
* Coordination of RightFax and SFTP site submissions; ensure completeness and appropriate filing of documentation; update the QM coordinators of received documentation; as needed, provider record request support to the QM coordinators.
* Participation in Unit and Division meetings, including but not limited to Huddle Board, QM Staffing, Case Resolution, Medical Director Review, Health and Safety, Clinical Staff, and DHCM Quarterly meetings.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Demonstrated experience using Microsoft Office (or comparable software program), Share Point, database manipulation, etc.
* Demonstrated experience in the principles and practices of medical/nursing and behavioral health services, medical terminology, and community health resources
* Strong working knowledge in the principles and theories of research and statistical analysis.
* Strong ability to prioritize workload; work independently and multi-task in a fast-paced environment.
* Strong oral and written communication skills.
* Ability to interpret and apply applicable rules, regulations, policies, and procedures to work
* Ability to work within a team as well as with Unit and Agency leadership
* One-two years working in a managed care environment, preferably within quality and/or within Arizona.
* Experience working in a behavioral health delivery setting.
* Three-four years as a Behavioral Health Technician
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 [email protected] or call 602-542-4700.