Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
First Resume Review: 01/02/2019
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 Health Care Management (DHCM) is looking for a highly motivated individual to join our team as a Reimbursement Administrator. This position will be responsible for establishing the reimbursement rates for all AHCCCS Fee-for-Service fee schedules, calculation of provider supplemental payments and provider assessments, operation oversight of provider incentive programs and related functions directly affecting the AHCCCS program budget for over $10 billion annually. Major duties and responsibilities include but are not limited to:
* Direct the establishment and maintenance of approximately two dozen fee schedules; determination of reimbursement rates; calculation of potential fiscal impacts; implementation and maintenance of rates.
* Direct the design, development, implementation and evaluation of new reimbursement methodologies; address issues surrounding reimbursement rates and methodologies; engage with provider community.
* Oversee supplemental payment calculations, payment approval and processing.
* Oversee the provider incentive programs including the Electronic Health Records (EHR) Program, the Targeted Investments (TI) Program, the Access to Professional Services Initiative (APSI) and various Differential Adjusted Payment initiatives; including provider eligibility determinations, payment approvals and issue resolution.
* Direct computation of assessment fees paid by hospitals and nursing facilities, track payment/non-payment of assessments, ensure proper follow-up action.
* Draft, develop and monitor State Plan amendments, Arizona Revised Statute amendments, Arizona Administrative Code revisions and agency policy.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Skilled in Microsoft Office or comparable computer software programs (e.g. word processing, spreadsheets and databases).
* Strong ability to work independently as well as lead teams; multi-task in a fast paced environment and project management to meet goals and deadlines.
* Research techniques for collecting, analyzing, interpreting and communicating results to others.
* Strong management and leadership skills.
* Demonstrated knowledge in claims and encounter payment data and ability to analyze payment data and prepare fiscal impact analyses within the regulatory guidelines for presentation to Executive Management, Legislative staff, consultants, other AHCCCS staff, etc.
* Demonstrated knowledge of medical fee-for-service rate setting for a health care insurer, preferably with State Medicaid program(s); and developing, implementing and evaluating payment systems.
* Demonstrated knowledge of the Electronic Health Records (EHR) program.
* Masters in Business Administration, Public Administration or Health Administration or closely related field.
* Five years of management/supervisory experience in a Managed Care Organization that includes financial analysis, provider rate setting; financial statement preparation or review; or auditing experience and supervisory responsibilities.
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.