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Program Services Evaluator 5

  • 510332
  • 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.

Program Services Evaluator 5

Job Details:

Address: 801 E. Jefferson Street, Phoenix, AZ 85034

Salary: $46,722 

Grade: 20

Open until filled: First review of resumes on (08/05/22)

Remote Statewide: 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:

OPEN TO AHCCCS EMPLOYEES ONLY​  

The Division of Member and Provider Services (DMPS) is looking for a highly motivated individual to join our team as a Program Services Evaluator 5 for the Provider Enrollment unit. The position is responsible for the oversight of various assignments that support the Provider Enrollment (PE) production units and Health Program Manager II’s that make PE determinations. This person will review escalated customer situations, provider disciplinary actions, and bring issues to the appropriate level for solution. Coordination of inter-agency and intra-agency endeavors is also needed as well as interacting with other state agencies, and the AHCCCS provider community. Major duties and responsibilities include but are not limited to:

• Support day to day operations with Provider Enrollment Customer Service Representative 4 and Health Program Manager II positions working with enrolling and maintaining 90,000 Providers and the AHCCCS Provider Enrollment Portal (APEP). Assign and track on-site visits.

• Research and resolve issues on escalated and urgent provider inquiries. Provide high level technical assistance for all issues related to Provider Enrollment. Provide internal and external customer service resulting from general inquiries from the Director’s office and AHCCCS management.

• Create, track, and maintain Provider Enrollment reports with analysis for various Provider Enrollment tasks, including but not limited to Board Restrictions, Medical Reviews, Site Visits, Enrollment Fee, and Fingerprint Criminal Background checks.

• Develop training materials and facilitate training to providers to enhance knowledge of the APEP.

• Represent the Provider Enrollment unit in settings within and outside of AHCCCS, including AHCCCS hearings related to Provider Enrollment. Participate in and/or contribute to the Arizona Management System (AMS).

• Due to COVID-19 precautions the recruiting process has been adjusted to meet the standard health guidelines outlined by the State. Interviews will be conducted virtually and may also be by way of video conference utilizing a platform like Google Meet/Hangouts or Zoom.

Knowledge, Skills & Abilities (KSAs):

Knowledge:
• Conducting research, troubleshooting, problem solving and root-cause analysis.
• AHCCCS and Provider Enrollment regulations and screening requirements
• Developing and presenting Provider instructional training

Skills:
• Interpersonal communication both written and verbal, negotiating and tactful explanations, interpreting and applying policies and procedures.
• Google, Word, Excel, Medicaid Programs and Prepaid Medical Management Information System (PMMIS) and AHCCCS Provider Enrollment Portal (APEP).

Abilities:
• Train and explain concepts, think analytically, collect, summarize and prepare reports and multitask and prioritize multiple assignments.
• Problem solve customer service issues in APEP and PMMIS.

Qualifications:

Minimum:
• Must have a high school diploma or General Equivalency Diploma (G.E.D).
• As determined by the Agency, some positions may be required to successfully complete a training program and/or pass a test appropriate to area of assignment.
• Some positions require fluency in a designed language.
• Some positions may require a valid driver's license.

Preferred:
• One year of Provider Enrollment OR; Program Services Evaluator eligibility experience.

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.