State Of Arizona Flagstaff , AZ 86002
Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Medical Eligibility Specialist Flagstaff Office
Pre-Assessment Screening (PAS Assessor)
First resume review: 09/30/18
This position will remain open until filled
Arizona Health Care Cost Containment System (AHCCCS), Arizona's Medicaid Agency, is driven by the passion to deliver comprehensive 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.
All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress. Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results. State employees are highly engaged, collaborative and embrace a culture of public service. Visit our careers page to learn more about AHCCCS. Use your skills to benefit others; join the AHCCCS Team!
The Division of Member Services (DMS) is looking for a highly motivated individual to join our team as a Medical Eligibility Specialist (PAS Assessor) for the Arizona Long Term Care System (ALTCS) in the Flagstaff Office. This position will assess customers of all potential populations, elderly and physically disabled (EPD), and developmentally disabled (DD) in both institutional and community-based settings to determine medical eligibility for long term care. Major duties and responsibilities include but are not limited to:
Assessing customers in a face-to-face interview using the Pre-Admission Screening (PAS) instrument to determine medical and occasionally financial eligibility for ALTCS.
Reviewing medical records and interacting with customer's family members, caregivers and/or physicians to identify and evaluate medical and psycho-social conditions.
Driving to customer's place of residence or various settings to conduct interviews and/or obtain pertinent medical documentation.
Conducting interviews with persons who are physically disabled, developmentally disabled or those who are elderly.
Referring customers to appropriate community resources, based on their needs.
Managing a heavy caseload with clearly identified and regularly monitored productivity and quality requirements.
Using a desktop computer/laptop and other computer programs for interviewing, updating, reviewing and completing medical eligibility determinations.
Phase 1 of the Candidate selection process requires completion of a writing exercise within a required timeframe. Candidates are contacted by email.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
Demonstrated knowledge of medical, functional and psycho-social problems of the elderly, physically disabled and developmentally disabled children and adults.
Demonstrated knowledge of medical terminology and procedures.
Demonstrated knowledge of available community resources, crisis intervention, counseling, advocacy, community relationships, and referral methods.
Fundamental principles of medical nursing services, alternatives to long term care, length of stay, pharmacology and equipment use.
Experience with caseload management; schedules and timetables; effectively prioritizing; analyzing, assessing and evaluating service provisions and quality of care.
Strong ability to establish and maintain effective working relationships with professional staff, caregivers, customers' families, children and adults and with representatives of courts and various other agencies in the community.
Strong ability to communicate effectively, both orally and in writing; reading, understanding and applying rules, regulations and policies.
Ability to elicit information and gain insight into customers and families; using a personal computer/laptop and computer programs to document information.
Ability to solve mathematic problems accurately.
Meet at least one of the following qualifications: Possess an active Arizona RN license; OR a Bachelor's or Master's degree in Social Work or closely related field and 2 years of experience providing social service case management; OR 3 years of experience providing social service case management that included individual planning and delivery of health care services
Must possess a current and valid Arizona driver's license
Experience with health care delivery systems and the use of appropriate channels to deliver health care services
Understanding of various medical interventions that pertain to the customer's diagnosis
Bilingual (Spanish) is a plus, but not required
At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan. Click here to learn more about benefits.
Arizona State Government is an EOE/ADA Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 417-4497. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. AHCCCS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.
Click the APPLY NOW button to submit your application.
For technical assistance, email [email protected] or call 602-542-4700.