Integrated Services Care Specialist

Arizona Department of Administration•Phoenix, AZ

1d•$47,999•Hybrid

About The Position

The Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Medicaid Agency, dedicated to delivering comprehensive, cost-effective health care to Arizonans in need. AHCCCS is recognized for excellence in workplace effectiveness, flexibility, high employee engagement, and supportive leadership, offering remote work opportunities. This specific position, an Integrated Services Care Specialist within the Division of Fee For Service Management (DFSM), supports the DFSM Continuation of Operations Plan (COOP) development and implementation. The role involves conducting support and follow-up for care coordination tracking and reporting of Care Coordination data. The specialist will lead care coordination projects, including maintaining SharePoint and HIE data platform users. As part of the Case Management System Units (CMSU) Care Coordination functions, this position will develop CMSU infrastructure for care coordination, including desk levels, process flows, and data flows. The role also involves collaboration with care coordination partners such as Regional Behavioral Health Authorities, Tribal Regional Behavioral Health Authorities, and IHS/638 facilities. Under the direction of the CMSU Integrated Services Administrator, the position will work closely with the CMSU care coordination team and support staff. This role requires in-office presence for member and provider communication outreach and unit support during site visits based on unit and divisional needs.

Requirements

Knowledge of: Behavioral Healthcare Delivery Systems
Knowledge of: Familiarity with Native American Tribes/ programs
Knowledge of: Member psychosocial and medical needs
Knowledge of: Medicaid, Medicare Federal Regulations, State Statute and Rule and policies applicable to AHCCCS programs
Knowledge of: ICD and HCPC codes
Knowledge of: Specific geography of Arizona and New Mexico and surrounding states
Knowledge of: AHCCCS and DFSM Policies and Procedures
Knowledge of: Familiarity of authorization and utilization review
Knowledge of: Medical technology computer data retrieval and input
Skill in: Problem solving skills
Skill in: Excellent verbal/written communication skills
Skill in: Organizational skills to coordinate, monitor and report
Skill in: Analytical skills to identify and correlate specific patterns, initiate investigations, submit findings and recommendations
Skill in: Strong interpersonal skills in working with people of diverse cultures and socioeconomic backgrounds
Skill in: Documentation and reporting of data and trends
Skill in: Intermediate computer skills (i.e. Microsoft Office Suite, Word, Excel, and Google)
Ability to: Strong ability to collaborate with others for mutually beneficial outcome
Ability to: Plan, organize, prioritize work, and multitask in a fast paced environment
Ability to: Understand clinical information
Ability to: Read, interpret, and apply complex rules and regulations
Ability to: Independent decision making yet knowing when to elevate the decision
Ability to: Support unit in-office based on business needs
Ability to: Work Virtual Office (VO), Telecommute or both
Two years of experience in a healthcare support role.
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.
Travel may be required for State business.
Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.)
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Nice To Haves

Experience in Behavioral Health
Prior experience working with Tribal entities.

Responsibilities

Provides support to the CMSU Care Coordination functions, including documentation for High Needs/High Cost clinical staffing, member eligibility, member rolls, and maintaining care coordination eligibility.
Responds to partner inquiries related to care coordination processes, and other miscellaneous issues.
Develop and implement CSMU infrastructure related to care coordination, including desk levels, process, and data flows, serve as lead for care coordination platforms, including the HIE and SharePoint.
Cross train CSMU staff in care coordination functions and provide back up to CSMU transportation, If needed.
Develop and implement COOP protocols and processes

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
Defined benefit plan that provides for life-long income upon retirement.
Required participation for Long-Term Disability (LTD) and ASRS Retirement plan.
Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period).
Voluntary participation in Deferred Retirement Compensation Program administered through Nationwide.
Tax-deferred retirement investments through payroll deductions.