Program Development Specialist Senior

1 month ago


Phoenix, Arizona, United States Arizona Official Website of State of Arizona Full time
Job Summary:

This position is responsible for managing, researching, and coordinating concerns related to network access to care of service providers. Having an understanding of federal and state regulations related to network requirements, Medicaid provider and managed care plan relations, as well as AHCCCS contract and policy requirements.

Key Responsibilities:
  • Monitor complaints against health plans related to network access to care issues, ensuring adequate network of service providers to meet the needs of the population, including tracking and managing complaints related to access to care.
  • Receive, review, research, and respond to access to care complaints received from internal and external stakeholders.
  • Oversee health plan deliverables, review for compliance and identify any potential access to care concerns.
  • Conduct assessment of network sufficiency by performing network surveys, outreach calls, and secret shopper calls to confirm member access to care.
  • Serve as a representative of the DHCS Network team in committees related to access to care.
Knowledge, Skills & Abilities (KSAs):
  • Knowledge:
    • Provider Network Planning, development, and monitoring
    • Behavioral health, long term care, and physical health service delivery system and operations
    • Medicaid provider and managed care operations
    • Licensure regulations
    • State Medicaid agency regulations
    • Managed care concepts
    • Medicaid provider and managed care options
    • Interpersonal communication/conflict resolution process
    • Project management
  • Skills:
    • Strong interpersonal skills to effectively relate to members and/or their families, multidisciplinary professionals, contractor representatives, and stakeholders
    • Analytical skills
    • Problem solving and trouble shooting skills
    • Group facilitation and organizational skills
    • Information collection and synthesis skills
    • Data analysis, interpretations, and reporting
  • Abilities:
    • Assess network sufficiency through a holistic perspective with emphasis on medical, social, environmental conditions and barriers for meeting unique needs
    • Communicate effectively both orally and in writing within all levels of the organization
    • Exercise initiative, judgment, and problem solving
    • Establish and maintain cooperative working relationships with leadership
    • Research and prepare comprehensive reports
    • Organize work to achieve goals and objectives
Requirements:
  • Minimum:
    • Two years of experience in healthcare and/or project management.
  • Preferred:
    • Bachelor's degree in Business or Healthcare Management and 3 years experience in healthcare and/or project management. Experience in working in a managed care provider or managed care provider relations environment.
Benefits:

Among the many benefits of a career with the State of Arizona, there are:

  • 10 paid holidays per year
  • Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
  • Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
  • Other Leaves - Bereavement, civic duty, and military.
  • A top-ranked retirement program with lifetime pension benefits
  • A robust and affordable insurance plan, including medical, dental, life, and disability insurance
  • Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
  • RideShare and Public Transit Subsidy
  • A variety of learning and career development opportunities
Remote Work:

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.

Retirement:

Lifetime Pension Benefit Program

  • Administered through the Arizona State Retirement System (ASRS)
  • Defined benefit plan that provides for life-long income upon retirement.
  • Required participation for Long-Term Disability (LTD) and ASRS Retirement plan.
  • Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period).
  • Deferred Retirement Compensation Program
  • Voluntary participation.
  • Program administered through Nationwide.
  • Tax-deferred retirement investments through payroll deductions.


  • Phoenix, Arizona, United States Arizona Official Website of State of Arizona Full time

    Job SummaryThe Senior Program Development Specialist plays a pivotal role in the Arizona Official Website of State of Arizona, serving as a subject matter expert on direct client service program development and assigned to one or more service program areas. This position requires expertise in substance use disorder assessment and treatment, parent...


  • Phoenix, Arizona, United States Southwest Human Development Inc Full time

    Job Title: Child Development SpecialistJob Description:Southwest Human Development Inc is seeking a Child Development Specialist to provide home visiting services to children and their families in Maricopa County. This role involves working with families in their homes to deliver services in a fun, engaging, and supportive way to help build stronger families...


  • Phoenix, Arizona, United States MSCCN Full time

    Job Title: Senior Specialist, Clinical SafetyAs a Senior Specialist, Clinical Safety, you will play a critical role in ensuring the safety of patients participating in clinical trials. You will be responsible for reviewing and handling adverse events in accordance with regulatory requirements, as well as developing and implementing training programs for the...


  • Phoenix, Arizona, United States Southwest Human Development Inc Full time

    Job DescriptionA positive future for every childSouthwest Human Development Inc is seeking a Home Visitor to empower and impact families for generations in our Healthy Families Program. This role provides home visiting services to children and their families in Maricopa County.Key Responsibilities:Implement the Healthy Families model and curriculum with...


  • Phoenix, Arizona, United States Diverse Lynx Full time

    About the Role:We are seeking a skilled Senior Data Integration Specialist to join our team at Diverse Lynx LLC.Responsibilities:Design, develop, and maintain Informatica ETL data pipelines.Collaborate with Snowflake and SQL to ensure seamless data integration.Maintain current data integrations and build new ones to meet business needs.Stay up-to-date with...


  • Phoenix, Arizona, United States undisclosed Full time

    Sales Program Specialist Job DescriptionJob Title: Sales Program SpecialistJob Summary: We are seeking a Sales Program Specialist to enhance our franchisees' sales processes and provide critical support from our corporate office.Key Responsibilities:Offer guidance and best practices for improving sales processes and closing techniques for franchise sales...


  • Phoenix, Arizona, United States Arizona Official Website of State of Arizona Full time

    We are seeking a skilled Senior Software Developer to join our company.To be successful in this role, you will need to have a strong background in software development, including experience with programming languages such as C and C++.Key Responsibilities:Write clean, efficient, and well-documented code.Collaborate with cross-functional teams to design and...


  • Phoenix, Arizona, United States Diverse Lynx Full time

    Diverse Lynx LLC is seeking a seasoned Senior Frontend Developer with extensive hands-on experience in front-end development, strong proficiency in ReactJS, and expertise in Java and open-source technologies.The ideal candidate will have strong experience in areas such as Java 8, React JS, RDBMS, Spring Boot, and Agile methodologies. Additionally, they...


  • Phoenix, Arizona, United States TEKsystems Full time

    Job Title: Senior API Security Specialist Job Description: The Senior API Security Specialist will serve as a subject matter expert in API security, performing threat modeling of APIs and playing an integral role in managing, monitoring, and reporting on API security risk reduction. Key Responsibilities:Conduct and facilitate day-to-day threat modeling of...


  • Phoenix, Arizona, United States Snell & Wilmer L.L.P. Full time

    Snell & Wilmer L.L.P. is seeking a highly skilled Senior Attorney Review Specialist to join their Office of General Counsel in the Phoenix office. The ideal candidate will have a strong knowledge of outside counsel guidelines, contracts, and the ability to build strong relationships with clients and colleagues.The Senior Attorney Review Specialist will be...


  • Phoenix, Arizona, United States Pacific Office Automation Full time

    Position Overview We are seeking a highly skilled Senior Field Equipment Specialist to join our team at Pacific Office Automation in the Phoenix, AZ area. This is a field-based position that requires excellent technical expertise and strong communication skills. Estimated Salary Range The estimated annual salary for this position is $65,000 - $85,000 based...


  • Phoenix, Arizona, United States Arizona Official Website of State of Arizona Full time

    About the Job:The Arizona Supreme Court, Administrative Office of the Court seeks a highly skilled and detail-oriented legal specialist to join its team. As a Senior Legal Specialist, you will be responsible for reviewing motions and petitions filed as habeas corpus or miscellaneous criminal matters at the direction of a staff attorney. This role also...


  • Phoenix, Arizona, United States Northern Arizona University Full time

    About the RoleWe are seeking a highly motivated and experienced Senior Student Development Coordinator to join our team at Northern Arizona University. This is a critical role that will provide strategic leadership and support to our student development programs, ensuring the success and retention of our students.Main Responsibilities:Collaborate with the...


  • Phoenix, Arizona, United States Ricoh Americas Corporation Full time

    Job SummaryWe are seeking a highly skilled and detail-oriented Senior On-Site Service Specialist to join our team at Ricoh Americas Corporation. As a key member of our operations team, you will be responsible for providing exceptional customer service, ensuring the smooth operation of our copier and mailroom services, and maintaining a high level of...


  • Phoenix, Arizona, United States Focused HR Solutions Full time

    Job DescriptionWe are seeking a highly skilled Senior Quality Assurance Specialist to join our team at Focused HR Solutions. The ideal candidate will have a strong background in software testing and quality assurance, with experience in developing test plans, test cases, and test scripts.The successful candidate will be responsible for:Developing and...


  • Phoenix, Arizona, United States Syntricate Technologies Full time

    Job Title: Senior Documentum and Java DeveloperJob Summary: We are seeking a highly skilled Senior Documentum and Java Developer to join our team at Syntricate Technologies. The ideal candidate will have extensive experience in all areas of Documentum platform engineering, including development, installation, configuration, administration, support, and...


  • Phoenix, Arizona, United States Jewish Family & Children's Service Full time

    Job Summary">The Program Management Specialist will oversee the daily operations of the program, ensuring seamless delivery of services to clients. This includes managing staff, monitoring program spending, and facilitating regular team meetings.Key Responsibilities:">">Oversee daily program operations, including supervision of staff, management of...


  • Phoenix, Arizona, United States JA Solar AZ LLC Full time

    Job DescriptionWe are seeking a highly skilled Senior Equipment Improvement Specialist to join our team at JA Solar AZ LLC. This role is responsible for leading the organization of major downtime anomalies, analyzing and implementing corrective actions, and ensuring 100% implementation of measures.Key Responsibilities:Lead the organization of major downtime...


  • Phoenix, Arizona, United States LHH Recruitment Solutions Full time

    Job OverviewAs a key member of our team, the Senior Mental Health Support Specialist will play a vital role in providing essential support to patients facing various serious mental health challenges.This position requires strong interpersonal skills and the ability to empathize with individuals experiencing mental health challenges.The ideal candidate will...


  • Phoenix, Arizona, United States Talus Development, LLC Full time

    Talus Development LLC, a leading telecommunications and utility contracting firm in Phoenix, Arizona, is seeking a highly skilled Fiber Optic Installation Specialist to join their team.As a Fiber Optic Installation Specialist, you will play a critical role in installing and maintaining fiber optic networks for our clients. Your expertise in splicing and...