Clinical Program Specialist (AZ Remote)

Blue Cross Blue Shield • Phoenix, AZ

387d • Remote

About The Position

The position is responsible for the development, implementation, and oversight of projects and programs related to the AHCCCS Children's System of Care. It serves as a liaison and single point of contact for the population and assigned programs, ensuring effective coordination of care and compliance with Medicaid regulations.

Requirements

• 2 years of experience in direct interaction with members in a behavioral health or social work setting.
• Bachelor's Degree in a behavioral health related field.
• Valid Arizona Driver License with an acceptable driving record.

Nice To Haves

• 5 years of experience in direct interaction with members in a behavioral health or social work setting.
• Master's Degree in a behavioral health related field.

Responsibilities

• Coordinate care between Medicaid Business Segment providers and community stakeholders.
• Provide subject matter expertise to internal and provider clinical teams.
• Assist in the development of projects and programs related to transition to adulthood.
• Monitor identified populations and programs for compliance with Medicaid regulations.
• Perform clinical oversight functions and review criteria-based clinical activities.
• Develop and implement Child and Family Team policy and training.
• Consult with providers, stakeholders, and Medicaid Business Segment.
• Coordinate and participate in state, regional, and local planning meetings.
• Maintain and update programmatic data and policies for reporting.

What This Job Offers

• Job Type: Full-time
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree