The Department of Economic Security, Division of Developmental Disabilities (DES/DDD) is seeking an experienced and highly motivated individual to join our team as a Quality Management Medical Director.
DES/DDD provides supports and services to over 45,000 individuals with intellectual and developmental disabilities (members) in the State of Arizona.
• This position will work in close coordination with the Division’s Chief Quality Officer (CQO) to oversee a wide variety of responsibilities from the Medical Director perspective, including: quality and clinical oversight/assistance in the provision of various community-based, inpatient and outpatient services for all members served by the Division.
• These tasks include the implementation and management of quality oversight, including the process of incident reporting and triaging concerns, appropriate fact-finding, and investigation of Quality of Care (QOC) concerns, oversight of division specific performance improvement plans (PIPs) and AHCCCS required PIPs.
• This position also provides oversight to vendor contracting and monitoring of vendor requirements, and the annual review of Quality Management (QM) policy and procedures.
• In addition, this position will oversee the submission of all AHCCCS required regulatory reporting requirements, along with the Annual QM Work Plan and QM Work Plan Evaluation.
• Supports the Quality Management staff ensuring timely and consistent responses to members and providers. Oversees Quality Management services, quality assurance and coordination with support coordination. Provides clinical guidance in promoting member quality of care and reviewing/addressing potential lapses to include Quality of Concern (QOC) investigations, addressing and reviewing QOC concerns.
• Provides clinical expertise and business direction in support of QM programs. Acts as lead clinical liaison to network providers and facilities to support the effective execution of DDD service programs by the clinical teams. Provides clinical oversight with the design and compliance of quality processes/activities. Proactively uses data analysis and periodic assessments to identify opportunities for quality improvement.
• Provides leadership, mentoring, coaching and direct supervision of staff. Completes Performance Appraisals (MAP), authorizes leave, and approves ETE Time Cards for staff.
• Provides oversight to providers and facilities and facilitates cooperation in the quality of care delivered to DDD members and assures that the shared relationships are maintained and improved.
• Provides clinical oversight in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement programs in accordance with regulatory, state, corporate, and accreditation requirements.
• Knowledge of clinical policies, protocols, standing orders and care management plans
• Knowledge of clinical guidelines and evidence based approaches to the provision of services to persons with Developmental Disabilities
• Knowledge of Federal Regulations related to Medicaid, Medicare, Federal and State laws, agency rules, policies and procedures for medical services in a managed care environment
• Knowledge of Quality Management principles Applicable laws, rules, policies, procedures and standards related to acute care delivery, nursing scope of practice, and quality assurance
• Knowledge of principles of group dynamics, relationships, and human development Developmental disabilities and Division philosophy of service provision
• Knowledge of Arizona Health Care Cost Containment System (AHCCCS), Department of Health Services, and Centers for Medicare and Medicaid
• Knowledge of the integrated health care system (Arizona Long Term Care System (ALTCS) - DDD, Behavioral Health (BH), Acute and Children’s Rehabilitative Services (CRS))
• Knowledge of Quality Improvement Project techniques or methodologies, such as: Rapid Cycle – Plan, Do, Study, Act (PDSA) or Plan, Do, Check, Act (PDCA)
• Knowledge of supervisory practices and procedures
• Skilled in time management
• Skilled in oral and written communication
• Skilled in effective "team participation" as well as "team management"
• Skilled in using computer software (e.g., Microsoft Word, Excel, databases, etc.)
• Skilled in analyze situations accurately and taking effective action
• Ability to lead and supervise
• Ability to evaluate data and documentation
• Ability to relate to people with varying levels of knowledge about mental illness and developmental disabilities
• Ability to work collaboratively with and gain the cooperation of others in the face of disagreement and dissent
• Ability to plan strategically and then execute the plan
• Ability to work within the context of a Managed Care Organization (MCO)
• Ability to Establish and maintain positive working relationships
• The preferred candidate will have two (2) - three (3) years of experience in Health Care Delivery Systems e.g., Clinical Practice and Health Care Industry. Two (2) years of Supervisory/Leadership experience in a clinical setting preferred. Clinical experience working with people with developmental disabilities and behavioral health disorders preferred.
• The candidate must possess a license to practice medicine in the State of Arizona granted by the Arizona Medical Board or the Arizona Board of Osteopathic Examiners or the ability to obtain such licensure prior to appointment.
• Must possess and maintain current Medical Board Certification in a Primary Care Specialty.
• In-state travel may be required. This position requires possession of and 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 record checks, must maintain acceptable driving records and must complete any required driver training (see Arizona Administrative Code R2-10-207.12.). 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.
• Employee shall have a valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-2758.07 in order to work with children and vulnerable adults.
• Candidates for this position shall be subject to a search of both the Child Protective Services Central Registry pursuant to A.R.S. 8-804 and the Adult Protective Services Registry pursuant to A.R.S. 46-459.
• Successfully pass background and reference check; employment is contingent upon completion of the above-mentioned process and the Agency’s ability to reasonably accommodate any restrictions.
We offer a competitive benefits package that is unmatched by the private sector and a culture that encourages team success and advocates for personal advancement.
-Affordable Health, Dental, Vision and Life and Disability Insurance
-10 holidays per year
-Paid Vacation and Sick time off - start earning it your 1st day
-Eligible to participate in the Public Service Loan Forgiveness Program (must meet qualifications)
-Contribute to, and participate in the Arizona State Retirement System
-Ride Share and Public Transit Subsidy
-Career Advancement Opportunities
-Opportunity to work remotely (home office) on an ad-hoc basis
For a complete list of benefits provided by The State of Arizona, please visit our benefits page
State employees are required to participate in the Arizona State Retirement System (ASRS), the State sponsored retirement contribution plan and the Long-Term Disability (LTD) program after a 27-week waiting period. The ASRS defined benefit plan provides for life-long income upon retirement. You will also have the option to participate in a voluntary deferred compensation program to take advantage of tax-deferred retirement investments.
On, or shortly after, your first day of work you will be provided with additional information about the available insurance plans, enrollment instructions, submission deadlines and effective dates.
For questions about this career opportunity, please contact Valerie Rice at (480) 673-0643 or email firstname.lastname@example.org
Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting (480) 673-0624. 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.
Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.