What are the responsibilities and job description for the Title: Management Analyst 3 position at Arizona Health Care Cost Containment System?
Job Summary :
A career in public service awaits you. COME JOIN OUR TEAM!
A great benefit of working for the State of Arizona is a fantastic work / life balance. State employees enjoy challenging work, popular remote work options, comprehensive health and wellness benefits, and career growth opportunities.
We are searching for someone who will be comfortable and confident working independently on our team. You’ll have the opportunity to take on complex issues and make solid decisions to implement what needs to be done. If you’re looking for a great foundational position where you will learn about health plans and work with contractors and be coached, mentored and trained to be successful in your career with AHCCCS - this is the position that you've been waiting for - Come join our team !
What You'll Do :
The position will serve as an encounter subject matter expert. Will provide analytical support and technical expertise for encounter (post adjudicated claim) operations. The position will also manage Contractor encounter submissions from EDI submissions to mainframe processing, ensuring accuracy, completeness, and timeliness.
Major duties and responsibilities include but are not limited to :
- Provide analytical support and technical expertise for encounter operations in all or some of the following areas claims / encounters, PMMIS (Prepaid Medical Management Information System) subsystems and reporting, technical and policy documents.
- Monitor Contractor encounter submissions, adjudicating pending encounters, while identify trends, areas of non compliance and provide detailed analysis following mainframe processing cycles.
- Utilize operational / management reports to ensure Contractors’ encounter processing meets all contractual requirements and benchmarks, reporting areas of non-compliance to Encounter Manager, implement and administer corrective action to return Contractor to compliance.
- Respond timely to external and internal points of contact with the encounter unit (i.e., Encounters and Transaction Portal Insight e-mail boxes, & SFTP Site).
- Lead the development and facilitation of encounter standard work, training, and education for internal and external stakeholders.
- Participate in Operational Review and Ad Hoc projects of the Contractors.
- Participate in State-wide AMS & LEAN initiatives, continually analyzing current processes for opportunities for automation and inefficient redundancies within the unit, department, and division.
Knowledge, Skills & Abilities (KSAs) :
Knowledge :
Skills :
Abilities :
Qualifications : Minimum :
Preferred :
Pre-Employment Requirements :
If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply : Driver’s License Requirements.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Benefits :
Among the many benefits of a career with the State of Arizona, there are :
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.
Learn more about the Paid Parental Leave pilot program here.
