Program Specialist

REMOTE OPTIONS, PHOENIX

State of Arizona

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Published 2 months ago

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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 Specialist

Division of Managed Care Services (DMCS)

Job Location:

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

Posting Details:

Salary: $70,400

Grade: 21

Open Until Filled

Job Summary:

Under the leadership of the Quality Management Manager and Quality Management Supervisor, this position participates in the oversight of quality management structure within the statewide managed care delivery system. This position will be primarily virtual with some in-office meetings and on-site investigations and reviews as needed. This position will also participate as needed in on-site investigations and reviews outside of normal business hours and weekends.
This position is responsible for the oversight and review of the quality-of-care concern investigation process involving behavioral health services and providers. The position is responsible for understanding the needs of stakeholders especially those of members with unmet health care needs, members diagnosed with developmental delays, members diagnosed with behavioral health conditions, members with special health care needs and families of children with special health care needs.
This position will work directly with all AHCCCS populations in a managed care structure, including physical health, behavioral health, and LTC Supports and Services. The position ensures acknowledgment of receipt of issues for investigation to members, AHCCCS Administration, the Governor's office, legislators and other advocacy groups to ensure that member issues and concerns have been investigated and resolved.
The position is responsible for increasing member satisfaction and improving risk management efforts for AHCCCS by resolution of quality-of-care complaints in a timely and comprehensive manner. Direct clinical knowledge and expertise is applied by this position in review and timely resolution …