Outdoors, Mountain, Nature, Person, Painting, Valley, Landscape, Scenery, Panoramic, Canyon

Apply Now

Not You?

Thank you

Deputy Inspector General-Provider Compliance

  • 510426
  • PHOENIX
  • REMOTE OPTIONS
  • AHCCCS
  • Full-time

AHCCCS

Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork

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.

Deputy Inspector General-Provider Compliance

Job Location:

Address:  801 E Jefferson St, Phoenix, AZ 85034

Posting Details:

Open until filled: 1st review of resumes on date 8/22/2022

Salary: $98,000 - $130,000 

Grade: 29

This position may offer the ability to work remotely within Arizona based upon the department's needs and continual meeting of expected performance measures.

Job Summary:

The Office of Inspector General (OIG) is looking for a highly motivated individual to join our team as a Deputy Assistant Director. This position reports to the Inspector General (IG) and exercises direct oversight of the Provider Compliance Section as well as supporting the Inspector General in the oversight of the Asset Forfeiture Unit, and all Provider Matters. Acts in a Principal Deputy Inspector General capacity overseeing all functions of the Office of Inspector General when the Inspector General is unavailable.

Major duties and responsibilities include but are not limited to:
● Manage Provider Compliance Section and assist in the oversight of the Asset Forfeiture Unit; developing high impact case work; being vigilant for Asset Forfeiture opportunities; and ensure Civil Monetary Penalties(CMP), Credible Allegations of Fraud (CAF), and settlement agreements are appropriate.
● Interact and brief the Inspector General (IG) regarding Special Projects and initiatives; federal and state cases; external audits, reviews and interrogatories; OIG strategic plan, annual goals and objectives. Provide research of data, policy, and contracts to provide information to Federal and state audits of AHCCCS and the OIG
● Continual review of Provider Compliance Units Report of Investigations (ROI); ensure the AHCCCS receives Return on Investments as appropriate; and ensure Settlements are proper; Ensure the evidence is consistent and supportive to the case Itself. Conduct complex financial analysis and document findings on staff Cases
● Assist the IG with negotiating final determination of over-payments, CMP's; settlements, Credible Allegations of Fraud, suspensions, Terminations, and forfeitures with IG approval and signature. Ensuring Program Integrity by verifying contractual obligations and auditing process improvement. Act as final authority in IG absence to include representing and conducting meetings and presentation with internal/external entities

Knowledge, Skills & Abilities (KSAs):

Knowledge:
● Medical health care operations and rules, to include eligibility, concerning the proper handling and accounting of patient trust accounts. Regulations that apply to the various providers who contract with AHCCCS. Basic financial and accounting principles. Criminal, civil and administrative law, Federal Medicaid/Medicare statutes, rules and regulations as they relate to Title 19. Various types of eligibility programs including but not limited to; Social Security Disability, Long Term Care program, supplemental Security Income, Temporary Assistance to Needy Families (TANF) program, and the Sixth Omnibus, Budget Reconciliation Act (SOBRA), Specific knowledge including the income and resource requirements for eligibility for each of these varied programs
● The incumbent must understand Asset Forfeiture and rules related to Racketeer Influenced and Corrupt Organization Act (RICO).

Skills:
● Computing, summarizing, and aggregating qualitative and quantitative data in an accurate and timely manner. Developing and using spreadsheets and other software tools. Interpreting and applying federal and state laws, rules, regulations, and procedures. Prosecution process. Terminations, Suspensions, Credible Allegations of Fraud, Civil Monetary Penalties, and Exclusion Matters.

Abilities:
● Motivate people and work within a team environment; increase engagement. Clearly state what is expected so that there will be no misunderstandings among employees; and communicate effectively. Function successfully in an orderly and purposeful manner in situations of stress or tension. Be honest, forward looking, competent and enable others to act appropriately. Speak publicly and testify. To assist, advise, support, and move forward the IG's vision, goals, and objectives. Collaborate and coordinate with Peers related to working with the IG and supporting the strategic direction of the IG

Qualifications:

Minimum:
● Five or more years’ experience providing direct supervision and executive management and overseeing the daily activities of a section. Or a Degree in Criminal Justice or related field or Certified Fraud Examiner (CFE) Certification, or Certified Professional Coder (CPC) and Four or more years of responsible investigative experience preferably in government, healthcare, law enforcement, insurance, or managed care organization.

Pre-Employment Requirements:

• Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees.
• 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 is required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.

Benefits:

Among the many benefits of a career with the State of Arizona, there are:
• 10 paid holidays per year
• Paid Vacation and Sick time off (12 and 13 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
• 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
• Opportunity to work 100% virtually or remotely on an ad-hoc basis (home office)

By providing the option of a full-time or part-time virtual/remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Retirement:

Lifetime Pension Benefit Program
• Administered through the Arizona State Retirement System (ASRS)
• 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).

Deferred Retirement Compensation Program
• Voluntary participation.
• Program administered through Nationwide.
• Tax-deferred retirement investments through payroll deductions.

Contact Us:

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov.
Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.

ARIZONA MANAGEMENT SYSTEM (AMS)

All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress.  Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results.  
State employees are highly engaged, collaborative and embrace a culture of public service.

The State of Arizona is an Equal Employment Opportunity Employer.