Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Operations Compliance Officer
First Resume Review: 04/15/2020
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 an Operations Compliance Officer. Under the general direction of the Operations Manager and Operations Administrator, this position will be responsible along with a team of individuals in the Operations Unit, for having a comprehensive understanding of federal and state regulation guiding the provision of managed care and for ensuring that all AHCCCS managed care organizations/contractors adhere to all applicable regulations as well as all requirements outlined in contract and in AHCCCS policy. Major duties and responsibilities include but are not limited to:
* Represent AHCCCS at meetings with contractors and other contractor professionals; participate in special projects related to Medicaid managed care, including rules teams, fraud prevention, contract development.
* Provide technical assistance to program contractors, providers, members and other internal and external customers.
* Organize and coordinate services and communication among AHCCCS divisions and program contractor administration for the purpose of identifying, resolving and monitoring program contractor management issues.
* Monitor contractor deliverables. Plan and conduct operational and financial reviews including review and analysis of documentation, design review tool and format, perform interviews.
* Develop reports on the results of operational and financial reviews, complete with corrective action plans. Monitor performance of contractors.
* Monitor and evaluate the development of new contractors who successfully bid for acute, behavioral health and long term care services.
* Prepare responses to contractors, state agencies, and others requesting technical assistance or expressing a concern or complaint related to the acute and long term care programs. Produce written policies, procedures and reports for the acute, integrated physical and behavioral health and long term care programs.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Knowledge of project management methodology and techniques to select a particular approach to analyze, develop or implement policy.
* Knowledge of statistical analysis, data analysis, and research methods.
* Knowledge of managed care principles and delivery systems. Including acute, behavioral health and long term care management principles and operations.
* Organizational skills that result in prioritization of multiple tasks.
* Excellent computer skills including Word, Access, Excel, PowerPoint and Outlook.
* Ability to analyze problems and develop effective plans for corrective action.
* Ability to communicate effectively both orally and in writing within all levels of the organization. Effectively lead and/or facilitate a team of professionals from within and/or outside the agency.
* Two to three years of experience in acute care, long term care and behavioral health service delivery.
* Bachelors or higher degree in Public Health, Social Work or Public Administration or closely related field.
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) 417-4678. 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 HRIShelpdesk@azdoa.gov or call 602-542-4700.