HEALTH PROGRAM MANAGER 2

Arizona State Government; Hyde Park Township (IL); Remote; USD 77,000; Full time

Job summary

An established industry player is seeking a Clinical Coordination RN to oversee healthcare services for children in foster care. This pivotal role involves ensuring compliance with healthcare regulations and providing technical assistance to various stakeholders. The ideal candidate will possess strong clinical problem-solving skills and the ability to manage complex cases effectively. With a focus on improving health outcomes for vulnerable populations, this position offers a chance to make a significant impact. The organization supports work-life balance with flexible remote work options, making it an attractive opportunity for dedicated professionals.

Benefits

Affordable medical, dental, and life insurance

Top-ranked retirement plans

Paid holidays

Vacation and sick time

Wellness plans

Deferred compensation plan

Qualifications

• Active Arizona RN License is required for this role.
• Experience with state and Medicaid rules preferred.

Responsibilities

• Oversee clinical healthcare services and ensure compliance with regulations.
• Coordinate care for children in foster care and manage complex cases.

Skills

Oral and written communication

Clinical problem-solving

Healthcare knowledge

Utilization review

Computer programs (Excel, Word, Outlook)

Education

Active Arizona RN License

Job description

DEPARTMENT OF CHILD SAFETY

The Arizona Department of Child Safety (DCS) is a social and human services agency whose mission is to successfully partner with families, caregivers, and the community to strengthen families, ensure safety, and achieve permanency for all Arizona’s children through prevention, services, and support.

HEALTH PROGRAM MANAGER 2

Job Location:

CLINICAL COORDINATION RN
3003 N Central Ave Phoenix, AZ 85012

Posting Details:

Salary: $37.0192 HRLY/$76,999.94 Salary

Grade: 21

Closing Date: Open until filled

Job Summary:

The Clinical Coordination RN is responsible for the oversight of delivery of clinical healthcare services for one or more of the following comprehensive clinical programs: Quality Management and Performance Improvement (QM/PI), Medical Management (MM), Behavioral Health (BH), Maternity and Family Planning (Mat and FP), Children's Rehabilitative Services (CRS), and Early Periodic Screening Diagnostic and Treatment (EPSDT). This position develops policies and procedures to ensure compliance with federal and state laws, and with Arizona Health Care Cost Containment System (AHCCCS). The Clinical Coordination RN provides technical assistance to DCS Comprehensive Health Plan (CHP) managers, administrative, and clinical staff.

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

Job Duties:

• Performs oversight and care coordination for health care utilization management, prior authorization, concurrent hospital review, and medication authorizations for children, including children with qualifying chronic health/medical conditions in foster care throughout the state of Arizona. Participates with case managers, DCS Specialists, and Medicaid in the service coordination of high risk/highly complex cases, which may involve evaluation of healthcare immediate jeopardy cases.
• Administers statewide AHCCCS mandated programs which includes process and policy development, reporting, auditing, correspondence, training, and program compliance.
• Represents DCS CHP in external meetings and other activities with DCS Specialists, caregivers, AHCCCS, health home/medical home, and other DCS CHP Unit Managers.
• Interprets and applies statutes, regulations, and AHCCCS policy and rules; develops reports, policies, correspondence, and other written materials of a complex and professional nature.
• Participates in identifying and addressing systemic issues using the DCS Management System; participates in policy/procedure development.
• Provides technical assistance to DCS CHP Senior management, Medical Directors, Unit Managers, and staff; responsible for staff development for non-clinical medical services.
• Other duties as assigned related to the position.

Knowledge, Skills & Abilities (KSAs):

Knowledge of:

• Healthcare, service authorizations, utilization review and coordination of health services.
• Health care administration as it relates to children in foster care.
• AHCCCS/Medicaid rules and policies with respect to children's health, and health plan operations.
• Clinical standards of care and the recognition of quality of care issues.

Skills in:

• Oral and written communication.
• Clinical problem-solving.
• Computer programs including Microsoft Excel, Word, and Outlook.

Ability to:

• Plan, organize, and administer clinical care coordination and oversight for children.
• Navigate Arizona's systems of care, the foster care system, and related agencies.
• Maintain confidentiality of member information in accordance with applicable standards and regulations.
• Identify problems, analyze situations, and rectify concerns.
• Work under pressure in a high pace environment.

Selective Preference(s):

Experience with state and Medicaid rules and policies with respect to children's health, and health plan operations.

Pre-Employment Requirements:

Active Arizona RN License; in good standing with AZ Nursing Board.
The ability to secure and maintain clearance from the DCS Central Registry.
The ability to secure and maintain an Arizona Fingerprint Clearance Card.

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:

The State of Arizona provides an excellent comprehensive benefits package including:

• Affordable medical, dental, life, and short-term disability insurance plans.
• Top-ranked retirement and long-term disability plans.
• 10 paid holidays per year.
• Vacation time accrued at 4.00 hours bi-weekly for the first 3 years.
• Sick time accrued at 3.70 hours bi-weekly.
• Deferred compensation plan.
• Wellness plans.

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 programhere. For a complete list of benefits provided by The State of Arizona, please visit our benefits page.

Retirement:

Positions in this classification participate in the Arizona State Retirement System (ASRS). Enrollment eligibility will become effective after 27 weeks of employment.

Contact Us:

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-255-3141 or by email [e-mail]. Requests should be made as early as possible to allow time to arrange the accommodation. Should you have any further questions regarding the interview process you can reach out to a member of our recruitment team at 602-255-2903 or by email [e-mail]. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.