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.

Compliance Project Manager

Division of Managed Care Operations (DMCO)

Job Location:

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

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: $76,450 - $78,100 

Grade: 22

Closing Date: Open until filled

Job Summary:

The position is 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.

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:
• 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, etc.
• 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 and/or conduct provider network availability/accessibility monitoring.
• Plan and conduct operational and financial reviews including review and analysis of documentation, decision 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.
• Interpret various administrative rules, regulations, policies, and procedures.
• Monitor and evaluate the development of new contractors who successfully bid for acute, integrated physical and 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, integrated physical and behavioral health, 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 & Abilities (KSAs):

Knowledge:
• Project management methodology
• Techniques to select a particular approach to analyze, develop or implement policy
• Statistical analysis, data analysis, and research methods
• Managed care principles and delivery systems
• Acute, behavioral health and long-term care management principles and operations
• Systems and business management principles including administration, support and financial structures and strategic planning
• AHC