• 515518

• PHOENIX
• REMOTE OPTIONS

• AHCCCS

• Full-time

AHCCCS

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.

Address:  801 East Jefferson Street. Phoenix, Arizona 85034

Open Until Filled

Salary: $68,000 - $72,000

Grade: 23

The Division of Health Care Management is seeking a HC Financial Consultant. This position has responsibility for managing FFS fee schedules as assigned, which may include any of the following: Hospital Outpatient Fee Schedule, Hospital Inpatient APR-DRG Program and Other Hospital Fee Schedule Methodologies.

Under the direction of the Hospital Rates Manager this position is responsible for reviewing, evaluating and recommending improvements in reimbursement rates and existing rate-setting systems and practices, developing reimbursement rates by analysis of fiscal impact to the state and financial impact on providers of various alternative cost coverage models; implements and maintains, by periodic payment system audits, the resulting fee schedules used to reimburse up to $3 billion in health care services each year. Produces complex financial estimates and related internal financial reporting addressing consistency of reimbursement rate actions with budget constraints, State Plan Amendments, and federal and state laws; reviews, analyzes and evaluates existing rate-setting and reimbursement policies and practices, designs and implements revisions.

Performs regular and ad-hoc auditing and analysis of service utilization, cost of provision, and financial impacts by specific populations, services, providers, locations and contractors; advises management on reimbursement rate issues, and on the financial effects of rate and policy changes, and other measures proposed to revise current practices. Implements DSH supplemental payment program, completes all legislative and CMS reports as required on an annual basis for the hospital program and studies legislation, administrative rules, policies, reports, and procedural guidelines, both state and federal, devises approaches to implementation, and advises management on the financial effects on AHCCCS health plan contractors and health care providers.

* Financial/fiscal data analysis methods;
* Statistical analysis and research methodology;
* Medicare and Medicaid payment regulations, and state and federal laws relating to the AHCCCS program;
* Rate-setting methodologies;
* Financial reporting, auditing and financial analysis
* Health care industry coding standards;
* Medical terminology;
* Healthcare measurement methodology, such as, utilization measurement;
* Working use of mainframe systems, such as TSO and CICS environments;
* AHCCCS mainframe databases, including claims and encounters, recipient files, provider files and reference tables;
* PC and mainframe computer system applications, programming and operations within the context of healthcare industry usage;
* Statistical programming;
* Managed care payment principles;
* AHCCCS and managed care service delivery systems, including the various types of services provided/required, service provider types and specialties incorporated into the AHCCCS programs along with the types of services provided; and
* Management theories and techniques, supervisory skills, staff motivation techniques, and performance evaluation and measurement.
* Financial statement review
* Auditing
* Analysis, research techniques and problem-solving skills to resolve operational problems and improve systems related to rate-setting;
* Internet research skills to track rate-setting issues, methodology updates, and federal requirements;
* Application of data analysis skills to extract and report service utilization from claims and encounter service data, and to use utilization data to analyze fiscal impacts of rate payment scenarios;
* Personal and mainframe computer systems and application software skills, such as, spreadsheet, word processing, financial/ accounting, database, and/or graphics software;
* Project management skills, including the development of project objectives, task analysis and work plans.
* Ability to analyze, summarize, interpret, understand and report data;
* Ability to analyze and synthesize financial and/or managerial data and complex payment issues;
* Ability to develop and apply rate-setting methods and make recommendations for rate changes;
* Ability to query mainframe (CICS and TSO environments) and personal computer
databases;
* Ability to specify system service requirements, communicate and work with information systems staff to create or revise data extracts, upload and download of data flies, production and ad hoc reports, rate system updates and the ability to enhance and update the AHCCCS fee schedule website;
* Ability to work and communicate with a broad spectrum of professionals internally and externally, and the ability lo effectively present information both orally and in writing; and
* Ability to write technical/analytical reports and work independently or as part of a team.

Minimum:
Coursework in intermediate/advanced level statistics, applied research methodology, computer application experience, accounting/finance/economics and healthcare/medical terminology.

Preferred:
Bachelor's degree in business, economics, finance, health administration, or a related field.

* 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 may be 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.

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

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 careers@azahcccs.gov.
Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.