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.

Quality Assurance Specialist

Division of Fee for Service Management (DFSM)

Job Location:

Address: 150 North 18th Avenue Phoenix, Arizona 85007

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: $47,999

FLSA Status: Non-Exempt

Grade: 19

Closing Date: Open Until Filled

Job Summary:

Under the direction of the DFSM Quality Assurance (QA) Manager, this position serves as the coordinator for DFSM QA activity and deliverable tracking, and develop infrastructure for QA activities, including developing and maintaining desk levels, process and data flows, coordinating internal and external meetings and follow up, develops spreadsheets, reports, etc., track deadlines, receipts, reviews and responses associated with QA deliverables, maintain confidential files, tracks and maintains the units' leave schedules. This position has in-office duties to address member and provider communication outreach and support the unit during site visits based on the unit and divisional needs.

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.

 

Major duties and responsibilities include but are not limited to:
• Provide support to the CMSU CM team functions, including care management & care coordination support functions such as monitoring, processing & distribution of care management referrals, outreach, documentation & follow up as directed, managing the Transition of Care ETI folder, CRS referrals, provider or member outreach & documentation & follow up as directed. Coordinates amongst the DFSM QA team, OOD QM, OIG, OGC and other stakeholders, including TRBHAs.
• Develops desk levels, spreadsheets, reports, and draft communications for the unit as requested. Maintain hard and/or electronic copies of files including but not limited to desk levels and process/data flow charts. Completes and maintains documentation of archived records/files. Sends external correspondence, tracks timelines for requests and responses.
• Schedule and provide unit support for internal and external meetings by preparing and distributing meeting materials and taking meeting minutes, coordinate follow-up from discussions and track resulting deliverables and agreements. May be required to be in office two to three days a week to support teams performing provider on-site visits with appropriate documents and materials.
• Works closely with other units, divisions, internal and external customers to facilitate quality related initiatives as directed by the QA Manager responding to inquiries as appropriate
• Perform research and data gathering as requested.

Knowledge, Skills & Abilities (KSAs):

Knowledge of:
• Behavioral Healthcare Delivery Systems
• Familiarity with Native American Tribes/programs
• Member psychosocial and medical needs
• Medicaid,