Arizona Health Care Cost Containment System (AHCCCS)
Phoenix, Arizona, United States
RATES ANALYST
Job Description
- 497662
- PHOENIX
- AHCCCS
- Full-time
Grade: 22
The Division of Health Care Management (DHCM) is looking for a highly motivated individual to join our team as a Rates Analyst in the Reimbursement Unit. The position will be responsible for the fiscal stability of AHCCCS payments for health care services, including developing and maintaining reimbursement fee schedules used to pay AHCCCS claims.
* Oversee the development of fee-for-service reimbursement rates for assigned fee schedules, including research, development, system implementation, internal and external distribution and ongoing maintenance.
* Perform fiscal impact analyses for proposed changes to reimbursement rates and methodologies; develop and present recommendations to management.
* Attend internal and external meetings serving as the agency's rate-setting expert, to answer questions, provide recommendations, and participate in problem solving and decision making.
* Research and analysis of alternative rate-setting methodologies, various administrative rules, policies and requirements, both state and federal, as they apply to fiscal responsibilities concerning rate-setting.
* Perform data analysis using statistical models and programs.
* Knowledge of reimbursement rate-setting, analysis and research methodologies
* Understanding of financial/fiscal data analysis methods and use of database programs, Microsoft Excel and SPSS
* Familiar with Medicare and Medicaid payment regulations and state and federal laws relating to the AHCCCS program
* Utilize analysis, research techniques and problem-solving skills to resolve operational problems and improve systems related to rate-setting
* Application of data analysis skills to extract and report service utilization from claims and encounter service data, and to use utilization data to analyze fiscal impact of rate payment scenarios
* Analyze, summarize, interpret, understand and report data
* Analyze and synthesize financial and/or managerial data and complex payment issues
* Bachelor's/Graduate degree in Business, Health Administration, Economics or related field.
* Coursework in intermediate level statistics, applied research methodology, accounting/finance, & healthcare medical terminology.
* Two-three years work experience in a managed care environment.
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.