This position provides consultative services, technical guidance, and administrative expertise to ASH staff, community organizations, ASH Leadership in the design, development, implementation, and evaluation of programs related to the investigations of Complaints, Grievances, Appeals, and Quality Reviews Hospital-wide. This position will also act as the primary point of contact for AHCCCS and other agencies as it relates to Quality functions.
-Provides technical assistance to ASH Quality Department personnel regarding docketing complaints, grievances, appeals (CGA), and Quality reviews, addresses issues related to the CGA and Quality review process consistent with state and federal law, processes requests for reviews and draft notices for the Office of CGA.
-Provides technical assistance, consultative services, and administrative expertise to agency staff, community organizations, and the Arizona Health Care Cost Containment System (AHCCCS), concerning grievances and appeals processes, and process data requests.
-Intakes, assigns, maintains, tracks, and processes all matters related to the CGA and Quality investigations Hospital-wide. Drafts acknowledgment letters. Assigns, dockets, tracks appeals received, coordinates and schedules mediation conferences, drafts confirmation letters, courtesy reminders, and decision letters.
-Acts as the primary point of contact and provides technical assistance for the public, AHCCCS, other state agencies, and other stakeholders as it relates to CGA or Quality Reviews. Performs critically important functions related to CGA and Quality, auditing of the case files, following up with ASH personnel on pending documents/responses (revised decisions, corrective action plans, etc.)
-Consult with appropriate personnel regarding program goals, objectives, accountability, and delivery of services.
-Contacts patients, advocates, ASH staff or ASH Leadership to obtain and disburse information necessary to complete research and reports.
-Tracks and compiles data for AMS purposes, including maintaining huddle board data and presenting metrics at huddle and staff meetings. Provides backup support for the staff as needed. Prepares Quality meetings (ARC, SHRC, UM, Workplace Violence, Quality Council, etc.), drafts minutes and agendas, and schedules meetings.
-Develops and utilizes effective monitoring and evaluation procedures for new and ongoing programs to assure program conformance and file integrity.
-Other duties as assigned as related to the position.
- Google Calendar, Sheets, and Documents
- Microsoft Office Products including Excel
- Electronic Health Records
-Principles and practices of administration and management, agency and program rules, regulations, and operating procedures.
-Managing multiple priorities and projects
-Establishing and maintaining effective working relationships
-Organizing workload and developing Standard Work
-Oral and interpersonal communications necessary to perform responsibilities
- Develop meeting minutes and agendas
-Think critically and problem solve
-Meet Deadlines and track deliverables
The ideal candidate will have:
High school diploma or equivalent and two years of experience in related field. Preference will be given for experience in the Behavioral Health field and/or experience in providing nursing care in a medical setting, and has experience in Quality of Care concerns and investigation processes.
A State Hospital employee must be able to obtain a valid Level One Fingerprint Clearance Card pursuant to A.R.S. § 41-1758.07.
Driving is required for State Business.
Employees who drive on state business require possession of and the ability to retain a current, valid state-issued driver’s license appropriate to the assignment. Employees who drive on state business are subject to driver’s license checks, must maintain acceptable driving records and must complete any driver training (See Arizona Administrative Code R2-10-207.11).
The State of Arizona provides an excellent comprehensive benefits package including:
− Affordable medical and dental insurance plans
− Paid vacation and sick time
− 10 paid holidays per year
− Wellness program and plans
− Life insurance
− Short/long-term disability insurance
− Defined retirement plan
− Award winning Infant at Work program
− Credit union membership
− Transit subsidy
− ADHS Student Assistance Pilot Program
For a complete list of benefits provided by The State of Arizona, please visit our benefits page
To help you build a financially secure future, the State makes monthly contributions to finance your retirement benefit. The State will make a contribution to the ASRS in an amount equal to your contribution. In other words, you and the State will each pay 50% of the total cost of the benefit. New State employees have a 27 week wait period for contributions to begin.
Arizona State Government is an EOE/ADA Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 220-6462. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. DHS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.
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.