Title: Tucson Medical Eligibility Specialist

Arizona Health Care Cost Containment System; Tucson (AZ); Remote; USD 51,000 - 60,000; Full time

Job summary

Join a leading healthcare agency as a Tucson Medical Eligibility Specialist. This full-time role involves determining medical eligibility for Arizona Long Term Care Services, conducting assessments, and collaborating with various professionals. Enjoy the flexibility of remote work options while making a meaningful impact in the community.

Benefits

Holidays

Paid leave

Parental leave

Insurance

Retirement

Loan forgiveness

Transit subsidies

Career development

Qualifications

• Fluency in Navajo required for some offices.
• Minimum 3 years social service case management or related healthcare experience.

Responsibilities

• Conduct comprehensive pre-admission screenings in various settings.
• Manage PAS caseloads and complete assessments within timeframes.
• Collaborate with agencies and communicate outcomes.

Skills

Effective communication

Caseload management

Researching medical info

Education

Healthcare/nursing degree

Social service case management

Job description

Tucson Medical Eligibility Specialist

• 533622

• REMOTE OPTIONS
• TUCSON

• AHCCCS

• Full-time

AHCCCS

Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.

AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.

Come join our dynamic and dedicated team.

Tucson Medical Eligibility Specialist

Division of Member and Provider Services (DMPS)

Job Location:

Address: 7202 E. Rosewood Street, Suite 125 Tucson, AZ 85710

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.

Posting Details:

Salary: $51,340

Grade: 20

First Review of Resumes: May 19, 2025

Job Summary:

The purpose of this position is to determine medical eligibility for customers applying for the Arizona Long Term Care Services (ALTCS) program. Comprehensive Pre-Admission Screenings (PAS) are completed during face-to-face interviews using a designated PAS instrument. The role involves working independently and driving either a state vehicle or personal vehicle to home and institutional settings to complete interviews and/or obtain documentation. Record actions taken on cases, maintain an electronic case file, and update the Health-e-Arizona Plus system. The specialist may also conduct financial eligibility interviews, complete applications, verify eligibility factors, and determine ongoing financial eligibility and share of cost. Fluency in Navajo is required for some offices.

The State of Arizona promotes a flexible, autonomous, and trusting work culture. Many employees participate in the State’s Remote Work Program, enabling work from home, offices, or hoteling spaces. All work should be performed within Arizona unless authorized otherwise.

Job Duties:

Major duties include:
* Drive to conduct comprehensive pre-admission screenings (initial and reassessments) in institutional and community settings, explaining benefits and rights.
* Manage PAS caseloads, schedule and document interviews, and complete assessments within timeframes using HEAplus.
* Review medical and relevant records, gather data, and interact with family, caregivers, physicians, and other professionals.
* Collaborate with agencies such as APS, DDD, and DCS.
* Communicate outcomes and provide community resources for ineligible customers.
* Attend staff meetings, participate in projects, and conduct financial eligibility interviews.

Knowledge, Skills & Abilities:

Knowledge: Medical, psychosocial issues, human development, medical terminology, laws, policies, community resources, cultural influences, healthcare systems, basic math.
Skills: Prioritizing, assessing, establishing relationships, effective communication, caseload management, calmness, documentation, evaluating healthcare systems, researching medical info.
Abilities: Fluency in Navajo, understanding laws and policies, proficiency with computers, adaptability to changing priorities.

Selective Preference(s):

Arizona Driver License. Minimum: 3 years social service case management or related healthcare/nursing degree with experience; or bilingual Navajo (Chinle). Preferred: Bilingual Spanish (other offices).

Pre-Employment Requirements:

* Complete E-Verify, background checks, and employment verification.
* Travel may be required; driver’s license and acceptable driving record needed.
* Use of personal transportation may be required, with mileage reimbursement.

Benefits:

Benefits include holidays, paid leave, parental leave, insurance, retirement, loan forgiveness, transit subsidies, and career development. Remote work options are available but management discretion applies.

Retirement:

Includes lifetime pension through ASRS and voluntary deferred compensation.

Contact Us:

Disability accommodations available; request early via email. The Arizona State Employment is an Equal Opportunity Employer.