AHCCCS

Address: 150 North 18th Avenue Phoenix, Arizona 85007

All AHCCCS Employees must reside within the state of Arizona. 

Salary: $55,000 - $70,400

Grade: 21

FLSA Status: Non-Exempt 

This position will remain open until filled. 

Provides administrative, technical, and liaison support to the Independent Oversight Committees (IOCs) to ensure compliance with statutory responsibilities and promote consumer rights. Coordinates committee meetings, trainings, presentations, and information exchange among AHCCCS, health plans, providers, DDD, and other stakeholders. Manages IOC requests and inquiries, provides technical assistance and problem resolution, supports quality management and oversight activities, assists with annual reports, and collaborates with internal and external partners to advance IOC and quality improvement initiatives statewide.

Major duties and responsibilities include but are not limited to:
• Attends monthly meetings of all Independent Oversight Committees within each region: Southern Arizona, Northern Arizona, Arizona State Hospital, Maricopa County, and DDD. Provide support, technical assistance and education to the IOCs, facilitate cross communication with AHCCCS, and provide problem-solving efforts as needed. Serve as the IOC subject matter expert for AHCCCS. Note: Some IOC meetings may occur after normal working hours.
• Manages the IOC inbox and facilitates problem resolution between the IOC, RBHA, DDD, ACC, Health Plans, with respect to issues such as untimely submission of reports, possible rights violations, under or over redacting of reports, QM portal upload errors, FTP server uploads for Arizona State Hospital, and Special Assistance Reports for the IOC, etc.
• Maintains records relating to the operation of each individual committee, including correspondence between AHCCCS and the committees, nomination forms, appointment letters, letters of authority (site visits), confidentiality agreements, reports, guidelines or by-laws, meeting minutes/agendas, potential member tracking for each committee, AHCCCS deliverables tracker, and AHCCCS task tracker for each committee, etc.
• Provides and arranges training or technical assistance including human rights, open meeting law, confidentiality, QM Portal, FTP server, AHCCCS AMPM policies, tracking and trending reports requests, special assistance, grievance, and appeals process, PSRB, peer support, etc. Routine training of the Independent Oversight Committee, and Office of Human Rights roles to assist the committee in determining no rights violations have occurred.
• Monitor CQM inbox utilizing established stand works. Triaging referrals received for potential QOC and systemic concerns. Complete initial research regarding noted member(s), health plan and sub-contracted providers utilizing various data systems and staffing cases with the QM Supervisor and or QM Manager for case assignments. Completing reviews of all other items not identified as a QOC/ Systemic concern and referring.
• Participate in QM oversight activities as needed, technical assistance, and focused studies/reviews, including the behavioral health delivery system, to ensure compliance with contractual and policy requirements for all lines of business. Follow-up on written reports, corrective action plans, notices to cure and sanctions as appropriate.
• Responsible for arranging presentations from requested employee advisors, consultants and or providers to help facilitate QM MCO meetings as scheduled. Providing technical assistance and facilitating problem resolutions. Participate in the development of improved processes and procedures to improve efficiency of the QM unit. Participate in special projects and reviews as assigned and assure completion within the designated timelines. Provide ongoing updates to leadership.
• Prepares monthly audit reports to ensure contractor compliance with Contract and AMPM standards related to the IOCs. Create tracking and trending reports as requested by the IOCs. Analyzes data to identify systemic trends within the AHCCCS system of care at the State, MCO and provider levels.
• Assist the IOCs, and ADOA (all others at AHCCCS), upon request, with the preparation of correspondence, annual reports, bylaws and guidelines, QM Portal documentation and reporting to include, SAR, IAD, IRF, QOC, etc, as to the form/formatting, redacting, and content. Work consistently with QM, OHR, OCOs, Legal, Compliance for the betterment of the members, we serve daily.

Knowledge of:
• Structure and operation of the behavioral healthcare system, Behavioral Health Services, case management protocols, utilization review protocols as related to assigned populations (e.g. Acute, behavioral health, long term care)
• Current standards of medical/behavioral practice and modes of delivery for acute and non-acute medical/behavioral care/services
• Arizona specific Civil/Human rights (Child/ DDD/SMI)
• SMI Administrative Grievance and Appeals process and Arizona Open meeting law requirements and Confidentiality requirements
• Laws and rules that apply to IOC committees and functions within AHCCCS policy and procedure relating to the HRC's and required reporting

Skilled in:
• Microsoft Word, Google, IOC application of the AHCCCS QM Portal, SharePoint, Adobe, iNet, FTP Server, etc.
• Analytical thinking and creative problem solving
• Excellent verbal and written communication and interpersonal skills with regards to engaging with members, contractors, and providers to facilitate resolution or presenting issues
• Strong interpersonal skills in working with agency management, and people of diverse cultures and socioeconomic backgrounds; project management to meet goals and deadlines

Ability to:
• Communicate to ideas in writing in a clear and concise manner
• Establish and maintain effective working relationships with a diverse population
• Be highly organized and manage multiple priorities within a demanding workload
• Work independently and in collaboration with colleagues to meet goals
• Work in a Virtual Office

Minimum:
• Three years direct experience in working in or within the behavioral healthcare system in Arizona.

• Experience with project management, data analysis and facilitating trainings and or presentations.

Preferred:
• Bachelor's or Master's degree in public health, psychology, social work, nursing, law, or a related field.

• Three to five years of direct work experience in providing or administering behavioral health services.

• Prior knowledge of Independent Oversight Committees and functions, SMI Grievance and appeals process, Open meeting Laws, and knowledge of Arizona Administrative Code R9-21.

• Bilingual (a plus).

• 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.