Title: Benefits and Eligibility Manager
Benefits and Eligibility Manager
Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.
AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.
Come join our dynamic and dedicated team.
Benefits and Eligibility Manager
Division of Member and Provider Services
Address: 1800 East Palo Verde Street Yuma, Arizona 85364
Open until filled: 1st review of resumes on 5/30/2023
OPEN TO AHCCCS EMPLOYEES ONLY
The Division of Member and Provider Services is looking for a highly motivated individual to join our team as a Benefits and Eligibility Manager for the Yuma ALTCS Office. This position supervises and manages a staff of medical eligibility specialist, financial eligibility specialist, and supervisors who are responsible for determining the eligibility of potential and continuing members who work with the administration of the Arizona Long Term Care (ALTCS), Medicare Savings Programs (MSP) and Medical Assistance - Specialty Programs (MA-SP). Position monitors reports; timely actions; oversees case completion; monitors and evaluates job performance; consults with management and supervisory staff to provide technical assistance; and assists the Regional Manager with office functions. Statewide travel with possible overnight stays.
Major duties and responsibilities include but are not limited to:
* Ensure that uniform interpretations and application of State and Federal laws, agency policies and rules and regulations governing ALTCS, MCS, and MA-SP programs and other related program activities are maintained. Resolving escalated issues and making referrals as appropriate.
* Monitoring the timeliness of eligibility determinations. Updating and utilizing reports to ensure determinations are made within 45 days. Following up with staff on cases approaching or exceeding the due date. Being proactive by ensuring timely determinations are made.
* Monitoring the quality of eligibility determinations. Completing pre-disposition QA reviews as needed. Following up with staff on QA findings. Developing corrective action plans in response to QA findings and being proactive by ensuring consistent quality determinations are made.
* Manage and develop financial and medical staff and supervisors. Conducting regular unit meetings to ensure information is given to staff in a timely manner; attending staff meetings. Holding weekly meetings to review pending reports. Meeting no less than monthly with direct reports for performance conferences.
* Champion AMS in Eligibility Operations and provide guidance, insight and support to the lag and lead goals at the administrative and operational levels. Mentor supervisors to develop an operationally efficient and highly performing engaged workforce. Creating and maintaining an atmosphere in support of division/ agency vision and culture resulting in high morale and employee involvement.
* Works with office logistics along with ordering and assigning computer, phone and other technology for employees.
* Participating in problem solving and/or planning work groups. Conducting orientation and on the job training for staff.
* Due to COVID-19 precautions the recruiting process has been adjusted to meet the standard health guidelines outlined by the State. Interviews will be conducted virtually and may also be by way of video conference utilizing a platform like Google Meet/Hangouts or Zoom.
* ALTCS Medical and Financial eligibility and MCS and MA-SP Federal and State rules, regulations, policies and procedures and of personnel rules, policies and proceduress
* Tasks and functions performed by ALTCS and MA-SP supervisors, financial and medical eligibility staff
* Quality Assurance (QA) process and how findings relate to the specific functions performed by staff
* Functions of other divisions and administrations and how their work affects the operations of MSP, MA-SP and ALTCS
* Establishing and maintaining effective working relationships with professional subordinates while evaluating their work and recommending changes
* Organizational skills for prioritizing, scheduling, coordinating and implementing workload
* Strong interpersonal skills to effectively manage staff and interact with program contractors, health plans and AHCCCS members
* Interpret, analyze and apply current laws, rules, regulations and policies
* Direct subordinates and determine work assignments
* Communicate effectively, both orally and in writing
* Two years of supervisory level experience or three years of professional experience related to health programs appropriate to the assignment including program planning and administration may substitute for the experience supervision; a Master's degree in a field appropriate to the assignment may substitute for one year of the required technical experience.
* Two years of supervisory level experience performing eligibility (Financial) work or two years’ experience performing medical eligibility work (PAS Assessor). Experience related to health programs in Aging, Developmental/Physical Disabilities or Mental Health, which include program planning or administration.
* Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees.
* Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
* Travel is required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.
If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Among the many benefits of a career with the State of Arizona, there are:
* 10 paid holidays per year
* Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
* A top-ranked retirement program with lifetime pension benefits
* A robust and affordable insurance plan, including medical, dental, life, and disability insurance
* Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
* RideShare and Public Transit Subsidy
* A variety of learning and career development opportunities
By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.
For a complete list of benefits provided by The State of Arizona, please visit our benefits page
Lifetime Pension Benefit Program
* Administered through the Arizona State Retirement System (ASRS)
* Defined benefit plan that provides for life-long income upon retirement.
* Required participation for Long-Term Disability (LTD) and ASRS Retirement plan.
* Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period).
Deferred Retirement Compensation Program
* Voluntary participation.
* Program administered through Nationwide.
* Tax-deferred retirement investments through payroll deductions.
Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing firstname.lastname@example.org.
Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.
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Pay: up to $58,495/year
Job Status: Full Time
Job Reference #: 518025