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VBP and Rates Analyst

  • 503231
  • PHOENIX
  • AHCCCS
  • Full-time
  • Closing at: Dec 7 2021 at 23:55 MST

AHCCCS

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. 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. AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona.

VBP and Rates Analyst

Posting Details:

Salary: $49,000 - $55,000 

Grade: 22

 

Job Summary:

The Division of Health Care Management (DHCM) is looking for a highly motivated individual to join our team as an VBP and Rates Analyst. This Value Based Purchasing and Rates Analyst position is responsible for supporting the AHCCCS Value Based Purchasing (VBP) manager and will develop and maintain reimbursement fee schedules used to pay AHCCCS claims. In this role, the position will collaborate with cross-functional teams to advance delivery system and provider payment initiatives that improve health outcomes while bending the cost curve.

Major duties and responsibilities include but are not limited to:

Job Duties:

• Working with the Rates and Reimbursement Unit, oversee the development of fee-for-service reimbursement rates for assigned fee schedules, including research, development, system implementation, internal and external distribution and ongoing maintenance. Perform fiscal impact analyses for proposed changes to reimbursement rates and methodologies; develop and present recommendations to management. Attend internal and external meetings serving as the agency's rate-setting expert, to answer questions, provide recommendations, and participate in problem solving and decision making. Perform data analysis using SPSS, Excel and other tools.

• Support implementation of existing AHCCCS VBP initiatives, including Directed Payments, Alternative Payment Models (APM), and Performance Based Payments (PBP). Inform the continued development of new and innovative models. Assist in preparation of relevant financial summaries, quality measure withhold and incentive calculations, AHCCCS policies, contract and capitation certification language, and public notices.

• Conduct research on emerging VBP trends, such as regulatory actions or new programs implemented in other states, and present findings and recommendations. Collaborate with clinical teams to incorporate quality performance measures into financial models and align VBP programs with the AHCCCS Quality Strategy.

• Assist with preparation of the required deliverables for submittal to the Centers for Medicare and Medicaid Services (CMS), including Section 438.6(c) preprints for Access to Professional Services Initiative (APSI), Pediatric Services Initiative (PSI), Differential Adjusted Payments (DAP),Targeted Investments (TI), Nursing Facility Directed Payments, and similar programs. Gather nationally calculated performance measures and summarize for CMS preprint reporting.

• Analyze and monitor MCO financial reporting on VBP initiatives, including review of contracts and detailed financial data, to ensure targets are achieved and reporting requirements are met.

Knowledge, Skills & Abilities (KSAs):

• Problem solving in variable situations requiring analytical, interpretive, evaluative, and/or constructive thinking within broadly defined policies and objectives. Knowledge of commercial and government health insurance analysis, including Value Based Purchasing models.

• Federal Regulations relating to Medicaid and Medicare.

• Excellent written and verbal communication skills.

• Present complex materials to diverse audiences.

• Research complex topics and present summary findings and recommendations. Manage multiple projects and competing deadlines.

• Collaborate effectively with cross-functional teams.

Selective Preference(s):

• Bachelor’s degree in finance, economics, statistics, health care management, or related field. Experience with Arizona market place or other Medicaid managed care environment.

• Experience with Value-Based strategies and contracting.

Benefits:

At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan.

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Contact Us:

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-417-4497.
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.