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.

ALTCS Case Management Manager

Division of Managed Care (DMC)

Job Location:

Address: 801 E. Jefferson Street, Phoenix, AZ 85034

All AHCCCS Employees must reside within the state of Arizona.

Posting Details:

Salary: $85,000 - $90,000

Grade: 25

Position will remain open until filled.

Job Summary:

There are two major areas of focus within this unit – case management (CM) and the Pre Admission Screening and Resident Review (PASRR) program. This position is responsible for effective program development, management and oversight of the ALTCS case management program and related care/services delivery to members served by the ALTCS Managed Care Organizations (MCOs).

This position providers leadership to the teams that are responsible for ongoing oversight of the MCOs that serve ALTCS members (both aging/those living with physical disabilities and individuals with intellectual/developmental disability diagnoses, including members with serious mental illness and other behavioral health needs).

This position leads extensive internal and external engagement to support members through development/maintenance of an effective ALTCS program centered around member-specific needs and effective case management strategies. Additionally, this position leads comprehensive delivery system monitoring related to member access to HCBS and institutional care, functional assessments of need, person-centered service planning, and ensures compliance with numerous aspects of federal/state requirements related to ALTCS services.

This position is responsible for drafting, implementing, and refining ALTCS-related policies and well as ensuring adherence to ALTCS-related contract and policy requirements (in collaboration with the AHCCCS Tribal ALTCS staff).
This position also works with numerous providers to ensure adherence to the PASRR program and related assessment needs of members who have institutional level of care needs. This manager position reported to the Deputy Assistant Director of ALTCS within the Division of Managed Care.

Major duties and responsibilities include but are not limited to:
• Ensure ongoing case management compliance by the ALTCS MCOs (case management service reviews, data reports, performance reports, operational reviews, and correction actions). Maintains regulatory active oversight of the ALTCS MCOs, including DDD Staff complex cases with MCOs and provide system navigation supports either directly or through coordination with MM or CRU. Collaborates with DFSM on the ALTCS Tribal Program and provide support re: federal regulations/oversight requirements. Ensure DFSM engagement in policy/program update efforts.
• Ensure ongoing oversight of specialized programs, including but not limited to Behavioral Health Reinsurance, Out-of-State placements and the federally mandated Pre-Admission Screen and Annual Resident Review (PASRR) program. Support provider questions regarding these efforts and work with ISD to maintain electronic systems for submission
• Develops programs, initiatives, processes, and improvements/maintains quality care coordination, case management, behavioral health services, home and community based services, disease management and healthcare education for ALTCS members. Oversees effectiveness of MCO-based case management programs in supporting members. Review data related to all these efforts and use to drive improvements to delivery system. Provide updates to leadership and st