Care Management Healthcare Consultant — Remote/Hybrid

State of Arizona; Phoenix (AZ); Hybrid; USD 60,000 - 71,000; Full time

Job summary

AHCCCS, Arizona Health Care Cost Containment System, seeks a Care Management Healthcare Consultant to apply clinical knowledge, coordinate and monitor service delivery, and review case materials for regulatory compliance. Hybrid work with in-office meetings and on-site investigations may be required.

The role emphasizes identifying systemic issues, providing stakeholder education, and leading special projects to improve health outcomes and processes within the Division of Fee for Service

Qualifications

• Excellent verbal and written communication to educate internal/external stakeholders.
• Strong organizational and time-management skills to handle multiple cases.
• Proven project management experience to lead multiple reviews and initiatives.
• Research and analytical skills to assess data trends and issues and drive resolution.
• Accurate documentation and reporting of data and trends.

Responsibilities

• Monitor compliance with State and Federal regulations and track case management data.
• Ensure quality of care to AHCCCS members and maintain respectful, person-centered service.
• Contribute to reviews of behavioral health delivery systems and policy compliance.
• Provide education and technical assistance on covered services to stakeholders.
• Lead special projects and develop improved processes to increase unit efficiency.

Skills

Communication

Organization

Project management

Research & analytics

Documentation

Education

Arizona medical license (RN or higher) or Arizona Behavioral Health license

Job description

AHCCCS, Arizona Health Care Cost Containment System, seeks a Care Management Healthcare Consultant to apply clinical knowledge, coordinate and monitor service delivery, and review case materials for regulatory compliance. Hybrid work with in-office meetings and on-site investigations may be required.

The role emphasizes identifying systemic issues, providing stakeholder education, and leading special projects to improve health outcomes and processes within the Division of Fee for Service