Management Analyst 3

Arizona Department of Administration•Phoenix, AZ

3d•Remote

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. Management Analyst 3 Division of Managed Care (DMC) Job Location: Address: 150 North 18th Avenue Phoenix, Arizona 85007 All AHCCCS Employees must reside within the state of Arizona. Posting Details: Salary: Up to $56,450 Grade: 20 FLSA Status: Exempt This position will remain open until filled. Job Summary: This position serves as a technical and analytical lead responsible for monitoring, auditing, and evaluating ALTCS program and MCO performance. The role develops data strategies, reports, dashboards, and audit methodologies to identify trends, risks, compliance concerns, and performance outliers across a variety of program areas, while validating data accuracy and reliability. Working closely with data teams and program subject matter experts, the position analyzes complex datasets, develops monitoring tools, evaluates program effectiveness, and implements proactive oversight strategies that support program integrity, policy compliance, and the quality of services provided to ALTCS members. It also ensures the secure and appropriate use of sensitive data and supports data-driven decision-making through advanced reporting and statistical analysis.

Requirements

Two years of management analysis experience appropriate to the assignment; OR four years of experience appropriate to the assignment; A Bachelor's or Master's degree in a field appropriate to the assignment will substitute for one or two years of the required experience respectively, but will not substitute for the management analysis experience.
Principles, methods, or tools for developing, scheduling, coordinating, and managing projects and resources
Health care industry, Arizona Long Term Care System (ALTCS) and managed care concepts and practices as well as obtaining knowledge of AHCCCS contracts and policies and the behavioral health delivery system in Arizona
State and federal health care laws and regulations
Theoretical and practical concepts of the health care market, State government organizations, operations, processes, and procedures, especially those related to program monitoring
Concepts and techniques associated with program evaluation, auditing, and regulatory oversight
Various types of data structures and forms
Data analytics
Manipulating large data sets to highlight relevant information in a digestible format
Developing detailed data requests
Developing guidelines/structures for ad hoc program audits
Development of program auditing/monitoring strategies and implementation of these strategies
Producing written information in a succinct and organized manner that is appropriate for intended audience(s)
Implementing/refining monitoring tools to support effective oversight
Effective communication, presentation, and research skills
Translating business needs to technical specifications and evaluating related inputs/outputs
Auditing multiple deliverables or data sets and determining accuracy/compliance
Work independently and be self-motivated
Interact, influence, and motivate internal and external stakeholders effectively to obtain pertinent information for decision making and to communicate directly and effectively
Effectively analyze data, identify risks, and develop responsive strategies to address as well as provide ongoing monitoring for sustainable improvements
Efficiently move projects forward meeting expected timelines
Develop and maintain effective working relationships
Effectively work with community advocacy and stakeholder groups
Manage multiple, high priority projects simultaneously
Design easily understandable data displays (e.g. charts, graphs, pivot tables) based off of raw data
Manage multiple audit strategies with competing priorities/timelines and effectively provide updates on each strategy as needed
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

Experience with insurance, healthcare claims, contract compliance, auditing, legal environment, Medicaid agency or Medicaid contractor.
Project Management Certification and/or Six Sigma Green or Black Belt Certification.

Responsibilities

Lead the development of complex, multi-factorial audit strategies for numerous areas of the ALTCS program, including creation and testing of appropriate methodologies, monitoring implementation, and analyzing data captured during the audit process.
Monitor, facilitate coordination and/or refine/update tracking criteria, and address questions and concerns related to current dashboards and program monitoring efforts across various programs/units; flag any observed risks and/or data abnormalities for ALTCS, division, and agency leadership review.
Maintain mindfulness of the vulnerabilities of the ALTCS population, the sensitive nature of the data, and the high visibility of program outcomes at both the state and federal levels.
Responsible for submission of new data requests to ISD, analyzing data reports and developing digestible/actionable monitoring tools, and leading a regular cadence of data review meetings for each team where metrics are being monitored.
Build out internal-facing ALTCS “dashboards” for specific areas of interest (e.g. members with Alzheimer's/dementia, longitudinal ALF and NF utilization, members with a TBI).
Support agency program integrity efforts in coordination with OIG and in alignment with federal priorities and/or findings from federal or state audits.
Develop and implement methods to audit against MCO self-reported data and/or federal/state-specific data from external sources (e.g. comparison of state or federal data to MCO-specific information).
Develop and/or refine methods of MCO-to-MCO comparisons and evaluation.
Lead teams in identifying areas of risk, trend identification, and/or future projects related to micro and macro aspects of populations served; educate teams on how to best engage in programmatic monitoring and ensure bi-directional flow of information, data, and related processes.
Work with other units to support broader efforts re: MCO oversight and population management (e.g. QI, QM, DMPS, ISD AODA, DMC Clinical and Ops teams).
Work with OIG to better understand risks/trends to enhance monitoring and oversight efforts.
Implement data-related improvements and/or monitoring efforts based on results of the NCI-AD survey, Federal Rule requirements (e.g. Access Rule, Managed Care Rule), and/or state or federal audits (e.g. PPCG audit).
Provide documentation of efforts as needed to respond to federal or state audits, as appropriate, to maintain and/or document compliance with federal and state laws/regulations.

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
Lifetime Pension Benefit Program
Deferred Retirement Compensation Program