Performance Strategy Administrator

The Division of Health Care Management (DHCM) is looking for a highly motivated individual to join our team as a Performance Strategy Administrator. This position is responsible for leading the Performance Improvement Strategy unit, which includes the Quality Improvement team, within the Division of Health Care Management (DHCM). This position will oversee the development and monitoring of quality measures and performance standards related to the implementation of the Hospital Enhanced Access Leading to Health Improvements Initiative (HEALTHII) and Health Care Investment Fund (HCIF) rate increase programs. This position will be responsible for working with Health Plans and providers to define appropriate measures and methodologies, working with consultants to develop and implement the measures, and preparing analysis and evaluation of the results to be reported to CMS. Additionally, this position will have a key role in the development and monitoring of performance metrics related to Value-Based Purchasing Initiatives and other CMS-approved financial incentive Pre-Print activities. This position will also lead the team responsible for development of several CMS deliverables, including the Agency's Quality Strategy, the annual External Quality Review, annual KidsCare metrics, and annual MACPro reporting. This position will serve as a performance strategy subject matter expert and will also advise on key Agency priorities such as the 1115 Waiver proposal and evaluation.

* Lead efforts to identify and/or develop and monitor appropriative performance measures for the HEALTHII and HCIF rate increase programs. Communicate measures to stakeholders and obtain assurances on measure appropriateness and feasibility. Formally document measures, methodologies, and related information.

* Lead efforts to identify and/or develop and monitor appropriative performance measures for CMS Pre-Print initiatives and the AHCCCS Value Base Purchasing program. Communicate measures to stakeholders and obtain assurances on measure appropriateness and feasibility. Formally document measures, methodologies, and related information.

* Lead/oversee the Performance Strategy/Quality Improvement area to maintain a coordinated, cohesive team that supports each other as well as other units/Divisions across the Agency. Meet all deliverable deadlines. Support positive morale, address issues and concerns, and proactively address barriers. Implement AMS principles in daily management.

* Collaborate with colleagues both within the Division and across the Agency to ensure aligned and appropriately supported performance improvement efforts. Lead development and provide feedback and support on greater quality strategies and ensure alignment with financial incentive performance activities and other Agency performance-based initiatives.

* Coordinate responses to regulatory requests for data such as those from State Boards, Governor's Office, legislators/Legislature, CMS, and other stakeholders. Support development of specifications for data queries, write responses, ensure review and approval by Division/Agency leadership, and submit timely/accurate responses back to requestors as appropriate.

* Provide technical assistance to Contractors and FFS providers, as appropriate. Promote effective and efficient performance improvement strategies for the AHCCCS care delivery systems, ensuring alignment with State and Federal strategies.

* Lead and/or participate in AHCCCS committees and meetings such as the Quality Steering Committee, Rates meeting, Clinical Oversight Meeting, and others. Provide clear and concise updates on performance-related data and activities and provide active engagement and decision-making on performance initiatives.

* State and Federal policies and procedures governing Title XIX, Title XXI, Managed Care, LTC duals, SMI, special health care needs and Tribal

* Managed care expertise, particularly in the areas of performance improvement and utilization/medical management and operational processes

* Methods to develop and administer managed care delivery systems, especially performance based initiatives and incentives

* Strong interpersonal skills in order to effectively relate to AHCCCS members and their families, multi-disciplinary professionals, and MCO representatives

* Excellent written and verbal communication as well as ability to assess needs of audience and adjust messaging as appropriate

* Assess members and member populations from a holistic perspective with an emphasis on recognizing medical, social, environmental and emotional conditions, barriers for meeting medical needs that interfere with the members ability to function within his/her limitations

* Develop, implement, and review quality improvement systems and the ability to offer technical assistance to Managed Care and/or Tribal Contractors as well as community stakeholders

* Certified Professional in Health Care Quality

* At least one year experience working in a managed care environment, preferably in a Medicaid program

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.

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

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-417-4497.
Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.