Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive and cost effective health care to Arizonans in need. AHCCCS is nationally acclaimed as a model for other Medicaid programs and recipient of multiple awards for excellence in workplace effectiveness and flexibility. Use your skills to benefit others; join the AHCCCS Team!
The Division of Fee for Service Management (DFSM) is looking for a highly motivated individual to join our team as the DFSM Deputy Assistant Director of Claims Operations. Position directs the operation of a constantly growing, centralized medical claims processing system. Major duties and responsibilities include but are not limited to:
Directs the operations of medical claims processing system responsible for processing an annual average of seven million claims, including oversight of approximately 60 staff.
Represents DFSM on agency-wide, Executive level task forces on key agency projects and initiatives.
Conducts public relations functions when dealing with Fee For Service providers, especially Indian Health Services, Tribal Consultations, Tribally owned and operated 638 facilities, other health care professionals and attorneys, and develops data to be presented to the Legislature, providers, and working closely with the care coordination unit on data reporting.
Provides key input to DFSM Leadership Team, to assure that projects are coordinated throughout the division and to contribute to the identification of division strategic plans, goals, policies and procedures.
Meets with various project managers, as needed, to assure that projects are running effectively. Represents DFSM Assistant Director both internally and externally as needed.
Develops and directs the Inter-governmental Agreements and TPA lines of business to process claims for other state and county entities, currently serving over 70,000 clients.
Manages the reference table structure for AHCCCS claims and encounters.
KNOWLEDGE, SKILLS AND ABILITIES:
Extensive management skills, with the ability to manage, motivate and maintain high morale for a large group of employees, and to delegate effectively.
Excellent skills/knowledge in validation and analysis of data; strategic and operational planning; formulating reporting mechanisms which are clear, concise and effective; problem identification and resolution; entitlement programs, financial management, state budgeting, personnel management, operations analysis and system design.
Knowledge of Federal Regulations relating to Medicaid and Medicare; Principals and practices of healthcare administration.
Knowledge of the provider community in Arizona, and extensive knowledge of the operations of Indian Health Service, Tribally owned or operated 638 facilities, Tribal health departments and Urban Indian clinics.
Ability to establish and maintain effective working relationships with subordinates, peers, and those in higher level positions.
Experience with project management of a large number of tasks/projects simultaneously, including measuring project performance and program outcomes.
Ability to formulate, design, and facilitate continuous improvements in processes and procedures.
Internal Number: Job ID: 54081
About Arizona Health Care Cost Containment System (AHCCCS)
Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents.