Health Program Manager 1
About The Position
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.
Requirements
- Two years of professional experience related to health programs appropriate to the assignment.
- Associates degree in a field appropriate to the assignment may substitute for one year of the required experience.
- Must reside in Arizona.
- Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
- All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Nice To Haves
- Bachelor's degree a healthcare related field and/or 2-3 years of work experience related in Analytics, Auditing, Health Care, or Behavioral Health.
- Strong computer skills, understanding of State and Federal policies and procedures governing Medicaid and Medicare and knowledge of PASRR policies and procedures.
Responsibilities
- Coordinate and monitor the processing of PASRR referrals and evaluations.
- Use clinical judgement to evaluate the accuracy and completeness of Level I and Level II submissions as well as to determine which third-party reviewer is best suited to address Level II submissions (behavioral health professional or intellectual/developmental disability professional).
- Maintain the PASRR mailbox/Portal and update the PASRR database to monitor and track clients.
- Provide support to providers by addressing inquiries and/or connecting providers with ISD or other appropriate resources.
- Resolve discrepancies and provide general problem solving efforts regarding the PASRR program (e.g. concerns, appeals, grievances).
- Assist with development and monitoring of the program policies and procedures, including performance audits to ensure conformance with federal and state laws, and all legal mandates.
- Support training initiatives and provide technical assistance to internal staff, MCOs and providers as needed.
- Interpret Federal and State rules and regulations.
- Maintain client records and referrals.
- Attend meetings, seminars and conferences related to program.
- Other duties as assigned as related to the position (typically 5% - 10%)
Benefits
- 10 paid holidays per year
- Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
- Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child.
- Other Leaves - Bereavement, civic duty, and military.
- A top-ranked retirement program with lifetime pension benefits
- A robust and affordable insurance plan, including medical, dental, life, and disability insurance
- Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
- RideShare and Public Transit Subsidy
- A variety of learning and career development opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
