• 531012

• 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), Arizonas 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 E. Jefferson Street, Phoenix, AZ 85034

All AHCCCS Employees must reside within the state of Arizona.

Salary: $110,000 - $116,000

Grade: 29

Position will remain open until filled.

The Deputy Assistant Director for the Division of Managed Care Services (DMCS) position is responsible for directing expansive clinical initiatives and frequently makes programmatic and policy decisions independently as well as on behalf of the DMCS Clinical/Operations Assistant Director and the AHCCCS Chief Medical Officer (CMO)/medical directors. The position is responsible for leading the DMCS clinical teams, including the Behavioral Health Grievance and Appeals, Medical Coding, Medical Management, Maternal Child/EPSDT, and Quality Management units. This position must also work closely with the Division of Managed Care Operations (DMCO) to ensure collaborative, coordinated efforts related to monitoring and oversight of the Managed Care Organizations (MCOs), policies, processes, and programs as well as ongoing clinical support to DMCOs Clinical Resolution Unit. This position leads and/or participates in numerous Agency and stakeholder initiatives related to clinical elements of member care and Managed Care Organization (MCO) operations. This position drives implementation of clinical initiatives, resolves clinically complex member and provider concerns, and promotes systemic improvement and/or sustainment of sound clinical practices at the MCO level.

This position leads/supports efforts related to significant stakeholder priorities and engages in numerous agency committees/workgroups (e.g. Financial Review, Coding and Benefits Review Team, Technology and Services) as well as addresses substantial policy and legislation-related work. The position will monitor workflow processes that facilitate timely completion of mission critical work as well as numerous state and federal deliverables. This position is responsible for program integrity specific to quality of care and quality outcomes, including chairing the health and safety committee, leading onsite investigative efforts of providers when critical concerns arise, and promoting ongoing adherence to strict confidentiality of quality issues. This position holds major roles in procurement initiatives such as MCO procurement, may be regularly called update as a witness and/or subject matter expert in agency-involved litigation, and will lead/take responsibility for the division in the absence of the Assistant Director.

Major duties and responsibilities include but are not limited to:
* Administration and oversight of the Clinical Units to maintain a coordinated, cohesive team. Serves as decision-maker for clinical programs/operations on behalf of CMO and DMCS AD.
* Lead and/or attend Division and Agency meetings/committees as well as external stakeholder meetings related to the clinical programs/initiatives. Represent DMCS at Medical Director, Medical Management, Quality Management, Dental Director, and other meetings. Actively participate in the Financial Review Committee and serve as an advisor to FRC staff in developing clinically-facing estimates.
* Review and interpret federal and state legislation/Rules, provide feedback related to potential impact to efficacy/efficiency of the Medicaid program. Develop/review AHCCCS policy to be consistent with regulations/ legislation. Able to make policy decisions and interpretations independently.
* Participation in RFPs, waiver development/evaluation, grant writing and other program development requirements. Coordinate and oversee contracts and intergovernmental agreements applicable to the Clinical units.
* Lead and/or support processes related to Immediate jeopardy/serious incidents or concerns involving immediate care needs/substantial impact to members, which may include immediate on-site evaluation of member health/safety. Serve as Agency authority related to incidents and coordinate with other state agencies to remediate emergent/urgent member concerns.
* Serve as a subject matter expert for issues, concerns, grievance/appeals, administrative hearings, legislative hearings, and/or legal proceedings related to clinical aspects of the managed care delivery system.

Knowledge:
* Federal and state regulations relating to Medicaid and Medicare
* AHCCCS rules, regulations, programs, policies and procedures
* Federal and state law and agency rules, regulations, policies and procedures for clinical services in a managed care environment
* Clinical Quality and Medical Management/ utilization review methods, practices and processes
* Research and statistical methodologies
* Committee structure, program review, and process improvement
* Claims and coding submission practices
* Clinical terminology
* Standards of care, especially for members who are vulnerable and/or diagnosed with clinically complex conditions
* Integrated healthcare principles
* Behavioral health care principles and Arizonas behavioral health delivery system
* HIPAA regulations and quality management confidentiality

Skills:
* Effective leadership of diverse clinical teams
* Strong interpersonal skills in dealing with staff, peers, Agency leadership, and external stakeholders
* Advanced computer skills; comfortable working in databases, developing presentations, charting data, and electronic management of emails, calendars, and tasks
* Effective organizational skills to coordinate and keep on-target a large number of high- priority programs and projects simultaneously.
* Personnel management, coaching, and professional development support
* Advanced analytical and problem-solving skills
* Producing professional technical reports, letters, and other items

Abilities:
* Work closely in a positive manner with the Governors Office, other state agencies, county officials, stakeholders, MCOs, etc.
* Effective/thoughtful public speaking and comfort with covering challenging topics
* Multi-task in a fast paced environment where re-prioritization occurs frequently
* Experience with the design, development and administration of managed health care programs
* Strong experience in managing, motivating, and leading high-level professionals
* Informed decision-making and personal/ team accountability
* Effectively prioritize and/or delegate work
* Work independently yet collaboratively with other units and/or Divisions
* Think critically, organize work flow, and modify existing processes with minimal supervision

Arizona Driver's License.

Minimum:
* Five or more years executive management experience providing direct supervision and overseeing the daily activities of a medical or clinical department OR; a Bachelor's degree in a healthcare related field and two or more years of responsible work experience in medical or behavioral healthcare settings to include supervisory experience.

Preferred:
* Advanced degree in healthcare administration or a clinical degree.
* Arizona licensed clinician or a Certified Professional in Healthcare Quality (CPHQ).
* Minimum of five years of progressive work experience in managed healthcare.

* 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 agencys 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.

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: Drivers 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)
* Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
* Other Leaves - Bereavement, civic duty, and military.
* 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.

Learn more about the Paid Parental Leave pilot program here. 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. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.