Management Analyst 4

Arizona Department of Administration • Phoenix, AZ

1d • Hybrid

About The Position

A career in public service awaits you. COME JOIN OUR TEAM! A great benefit of working for the State of Arizona is a fantastic work/life balance. State employees enjoy challenging work, popular remote work options, comprehensive health and wellness benefits, and career growth opportunities. The State of Arizona ranks #30 in Healthiest 100 Workplaces in America! This recognition honors organizations that champion employee wellbeing through innovative health programs, inclusive wellness initiatives, and a culture rooted in care.

The Division of Business and Finance (DBF) is looking for a highly motivated individual to join our team as a Value Based Purchasing (VBP) and Differential Adjusted Payment Analyst. The Value Based Purchasing (VBP) and Differential Adjusted Payment Analyst is responsible for supporting the development and implementation of AHCCCS Value Based Purchasing strategies and Differential Adjusted Payment initiatives. This position will work under the direction of the VBP Manager within the Division of Business and Finance. In this capacity, the Analyst will collaborate closely with cross-functional teams—including actuarial, clinical, financial, operational, rates and reimbursement, and policy units—to advance delivery system and provider payment initiatives aimed at improving health outcomes while containing healthcare costs.

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.

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.

Requirements

• Three years of managing analysis experience appropriate to financial data.
• A bachelor’s or master’s degree in finance or economics will substitute for two years of required experience.
• Data processing principles, concepts and current practices within AHCCCS and the Contractors
• Claims/Encounter processing, concepts and industry practices
• Appropriate techniques for the analysis of encounter information
• Encounter Data methodology and operations
• Understanding of contractual requirements, policy and procedures related to the submission and oversight of encounter submissions
• Research methodologies
• Professional standards, methods, forms and procedures for the reporting of medical claims/encounter information
• How data is used in research investigations
• Knowledge of Medicaid/Medicare programs and services
• Versed in ICD-9, ICD-10, CPT/HCPCS coding and National Drug Codes
• Thorough knowledge of computerized Prepaid Medicaid Management Information System (PMMIS) and the Transaction Insight Portal
• Word, Access, Excel, Power-point and Outlook
• Team and interpersonal skills
• Oral and written communication skills, including grammar
• Problem solving as it relates to position
• Organizational skills
• Analyze complex problems and draw logical conclusions based in information from several sources, including plan surveys, and discussions with technical personnel
• Determine if criteria meet research needs
• Interpret and understand documented medical information of a more complex nature
• Express technical information in a clear and concise manner
• Calculate basic statistics
• Communicate effectively when interacting with persons in a variety of settings, including personnel from Contractors
• Obtain cooperation of Contractors and secure acceptance of recommendations
• Speak and write effectively
• Use various computer software applications
• 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

• Bachelor’s degree in business, economics, finance, health administration, or related field.
• Experience Medicaid managed health care programs.
• Coursework in intermediate level statistics, applied research methodology, accounting/finance, & healthcare medical terminology.

Responsibilities

• Support implementation of existing AHCCCS VBP initiatives, including Directed Payments, Alternative Payment Models (APM), and Performance Based Payments (PBP). Inform the continued development of new and innovative models. Prepare relevant financial summaries, quality measure withholds and incentive calculations, AHCCCS policies, contract and capitation certification language, and public notices.
• Prepare State Plan Amendments for outpatient, inpatient, and nursing facility services, along with all required follow-up documentation and actions necessary to obtain CMS approval. Maintain a 100% on-time completion rate for all DAP milestone deliverables, including all ancillary components required to ensure timely and accurate DAP payments.
• Support implementation of existing AHCCCS VBP initiatives, including Directed Payments, Alternative Payment Models (APM), and Performance Based Payments (PBP). Inform the continued development of new and innovative models. Prepare relevant financial summaries, quality measure withholds and incentive calculations, AHCCCS policies, and contract and capitation certification language.
• Engage and consult with stakeholders, including providers, managed care organizations (MCOs), and agency leaders and clinical staff, to inform VBP strategies. Collaborate with clinical teams to incorporate quality performance measures into financial models and align VBP programs with the AHCCCS Quality Strategy.
• Assist with the facilitation of communication with internal and external stakeholders.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level