AHCCCS

Address:150 North 18th Avenue Phoenix, Arizona 85007

Must reside in Arizona.

Salary: $85,000 - $95,000

Grade: 24

FLSA Status: Exempt

This position will remain open until filled. This position will be 100% virtual office with the occasional requirement to meet in the office for meetings.

This position serves as an agency resource for Federally Qualified Health Clinics (FQHC) and Rural Health Clinics (RHC) related rates, policy, and reimbursement. The position will serve as the subject matter expert on FQHCs and RHCs in relation to financial matters regarding this provider type. They will be responsible for all aspects of FQHC and RHC rate and reimbursement topics including but not limited to; rate setting, reconciliation, supplemental payment, scope changes, and other related items. This role will have direct line of communication with external stakeholders.

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.

Major duties and responsibilities include but are not limited to:
• Become an expert and administer AHCCCS FQHC/RHC rates and reimbursement policies and standard operating procedures. Critically review AHCCCS' FQHC/RHC policy and standard operating procedures and conduct a comparison of current rate coverage to Medicare and other Medicaid agencies to identify differences and areas of improvement. Become familiar with all aspects of FQHC/RHC services and billing impacting rates and reimbursements. Lead the FQHC/RHC work-groups (both internal and external) and other FQHC/RHC meetings as a rates and reimbursement subject matter expert. Responsible for communicating changes to FQHC/RHCs and other essential stakeholders, and ensuring AHCCCS guidance, SPA, and other items are updated and stakeholders are notified of changes.
• Responsible for the FQHC annual reconciliation for over 40+ facilities, ensuring Health Centers are paid appropriately for visits during the reconciliation time period and ensuring that AHCCCS is a good financial steward. Responsible for calculation of quarterly supplemental payments and applicable communication with health centers.
• Responsible for oversight and implementation of the FQHC/RHC rebase every 3 years while identifying areas for improvement. This includes calculation of payments, communication and oversight of the rates. On off years responsible for calculating yearly rates based on a percentage increase, ensuring the rates are calculated according to the State Plan.
• Provide support and guidance on CMS State Plan amendments and questions from CMS by assisting with research, responses, and data analysis as assigned.
• Communicate with FQHC/RHC's for submission of financial information and other materials needed to rebase rates or perform reconciliations. Also responsible for communicating with FQHC/RHC's about agency rates and reimbursement policy and payment issues.
• Other duties as assigned as related to the position (typically 5% - 10%)

Knowledge:
• Health care reimbursement, financial statement preparation & analysis
• Medicare Cost Report & Uniform Accounting Report preparation & analysis
• Research techniques for collecting, analyzing, interpreting & communicating results to others
• Health care, including concepts of health care management, operations, and prepaid managed care programs
• Title XIX & the Social Security Act
• AHCCCS rules & regulations, operating policies & procedures, the Center for Medicare & Medicaid Services (CMS)
• Coding rules

Skills:
• Proven advanced, analytical, and modeling skills
• Proficient in the use of sophisticated analytical software programs such as SPSS
• Analysis, evaluation & resolution of complex problems
• Excellent interpersonal skills in one-on-one as well as large groups
• Effective collaboration skills with a diverse work force
• Project management to meet goals and deadlines
• Effective written & verbal communications

Abilities:
• Effectively lead and/or facilitate a team of professionals from within and/or outside the agency
• Multi-task in a fast paced environment
• Produce work products with limited supervision
• Collect, analyze & interpret charge & cost data relating to AHCCCS covered service programs & reimbursement policies & procedures

Minimum:
• Bachelor's Degree in economics, business, finance, healthcare, policy, or related field and 4 years of related experience(OR equivalent experience).

Preferred:
• Master Degree in economics, business, finance, healthcare, policy and 2-3 years working in a healthcare environment.

• If selected for an interview you will be required to complete a skills assessment for this position.

-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.) 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.

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

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 (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. Learn more about the Paid Parental Leave pilot program here.
• 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

By providing the option of a full-time or part-time 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.

Learn more about the Paid Parental Leave program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

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.

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. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.