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.

Flagstaff Medical Eligibility Specialist

Division of Member and Provider Services (DMPS)

Job Location:

Address: 2717 North Fourth Street, Suite 130 Flagstaff, Arizona 86004

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

Posting Details:

Salary: $51,340 

Grade: 20

Closing Date: Open Until Filled

First Review of Resumes: February 24, 2025

Job Summary:

The purpose of this position is to determine medical eligibility for customers applying for the Arizona Long Term Care Services (ALTCS) program. Comprehensive Pre-Admission Screenings (PAS) are completed during a face-to-face interview using a designated PAS instrument. Work independently and drive either a state vehicle or their personal vehicle to home and institutional settings to complete interviews and/or obtain documentation. Record actions taken on cases, maintains an electronic case file and updates the Health-e-Arizona Plus. A Medical Eligibility Specialist (PAS Assessor) may also be required to conduct financial eligibility interviews, complete applications and other forms and obtain verification of eligibility factors to determine the customer's initial and ongoing financial eligibility and share of cost. Some offices require fluency in Navajo.

The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.

Job Duties:

Major duties and responsibilities include but are not limited to:
• Drives a state or personal vehicle to conduct comprehensive interactive pre-admission screenings (initial and reassessments) utilizing HEAplus on all age groups in both institutional and community settings. Explains benefits, eligibility requirements and rights and responsibilities to customers.
• Manage and monitor PAS caseload and timeliness, schedule interviews, enter interview notes and score PAS, document follow-up actions with case notes, complete and close PAS assessments within application timeframes utilizing HEAplus.
• Obtains and reviews medical records and other relevant records; gathers data to support eligibility findings; interacts with informants such as family members and caregivers of customers, physicians and other professionals to identify and evaluate medical and psychosocial conditions.
• Interact with other state agencies such as Adult Protective Services (APS), Division of Developmental Disabilities (DDD) and Department of Child Safety (DCS).
• Contact applicants with the outcome of the PAS assessment and provide appropriate community resources for customers determined not eligible.
• Attends staff meetings and participates in exchange of professional information in support of the program. Works on special projects, completes financial eligibility interviews.

Knowledge, Skills & Abilities (KSAs):

Knowledge:
• Medical, functional and psycho-social problems of the elderly, physically disabled and developmentally disabled