PROGRAM SPECIALIST Job Vacancy in State of Arizona Phoenix, AZ 85007 – Latest Jobs in Phoenix, AZ 85007 – updated today

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Company Name : State of Arizona
Location : Phoenix, AZ 85007
Position : PROGRAM SPECIALIST

Job Description : The Division of Health Care Management (DHCM) is looking for a highly motivated individual to join our team as a Program Specialist. The 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 communication and collaboration with contracted health plans, participating in the development, implementation, and monitoring of the quality care management functions within DHCM Clinical Quality Management Unit, other divisions with AHCCCS, and other State agencies. After initial training and orientation, the position will be primarily virtual (work from home) with some in office meetings.

The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona, unless an exception is properly authorized in advance.

Job Duties:

Major duties and responsibilities include but are not limited to:

Participate in operational reviews, technical assistance, and focused studies/reviews, including the behavioral health delivery system, to ensure compliance with contractual and policy requirements for all lines of business. Follow-up on written reports, corrective action plans, notices to cure and sanctions as appropriate.

Receive, research, document, and resolve quality of care issues utilizing standardized processes and centralized database. Track, trend, and monitor status of case to ensure thorough and timely completion as well as appropriate referrals. Primary emphasis will be place on special populations such as those utilizing behavioral health services.

Ensure research and resolution of quality-of-care issues in a timely manner as assigned and identify systemic issues for AHCCCS to address.

Ensure quality of Care to AHCCCS members, including ensuring member health and safety as well as dignity and respect. Focus on unique aspects of each case, individual care needs, timely correspondence with members, and timely acknowledgement of concerns as well as resolution of the issue. Use appropriate judgement regarding data to research, regulatory, status level, interventions, and appropriate resolution.

Provide technical assistance to contractors and FFS providers, as appropriate, regarding contractual and/or policy requirements to improve quality of care and service delivery to AHCCCS members. Participate in special projects and reviews as assigned and assure completion within the designated timelines. Provide ongoing updates to leadership.

Participate in the development of improved processes and procedures to improve efficiency of the QM unit. Participate in special projects and reviews as assigned and assure completion within the designated timelines. Provide ongoing updates to leadership.

Coordinate and complete tracking, evaluation, and response to contractor deliverables.

Knowledge, Skills & Abilities (KSAs):

Behavioral Health Services, case management protocols, utilization review protocols as related to assigned populations (e.g. Acute, behavioral health, long term care)

Knowledge of current standards of medical/behavioral practice and modes of delivery for acute and non-acute medical/behavioral care/services.

Structure and operation of the Arizona Behavioral Health System.

Techniques to select a particular approach to analyze develop or implement a policy, project management methodologies and Behavioral Health System.

Strong interpersonal skills in working with agency management, and people of diverse cultures and socioeconomic backgrounds; project management to meet goals and deadlines.

Assess members from holistic perspective with an emphasis on recognizing medical, social, environmental, and emotional conditions, barriers for meeting medical needs that interfere with the member’s ability to function at an optimal level.

Communicate orally and in writing with members, contractors, and providers to facilitate resolution or presenting issues.

Selective Preference(s):

Certified Professional healthcare Quality

At least two- year professional healthcare industry in Quality or Utilization Management or five years of experience in behavioral Health Field, preferably in the context of the delivery of service in Arizona’s public behavioral health system.

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. By providing the option of a full-time or part-time 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

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.

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