Internship Cms Auditor Jobs (NOW HIRING)

A career in public service awaits you. COME JOIN OUR TEAM!

A great benefit of working for the State of Arizona is a fantastic work/life balance. State employees enjoy challenging work, popular remote work options, comprehensive health and wellness benefits, and career growth opportunities. The State of Arizona ranks #30 in Healthiest 100 Workplaces in America! This recognition honors organizations that champion employee wellbeing through innovative health programs, inclusive wellness initiatives, and a culture rooted in care.

What You'll Do:

The Division of Business and Finance (DBF) is looking for a highly motivated individual to join our team as a Value Based Purchasing (VBP) and Differential Adjusted Payment Analyst. The Value Based Purchasing (VBP) and Differential Adjusted Payment Analyst is responsible for supporting the development and implementation of AHCCCS Value Based Purchasing strategies and Differential Adjusted Payment initiatives. This position will work under the direction of the VBP Manager within the Division of Business and Finance. In this capacity, the Analyst will collaborate closely with cross-functional teams-including actuarial, clinical, financial, operational, rates and reimbursement, and policy units-to advance delivery system and provider payment initiatives aimed at improving health outcomes while containing healthcare costs.

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.

The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State's Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.

Major duties and responsibilities include, but are not limited to:
Support implementation of existing AHCCCS VBP initiatives, including Directed Payments, Alternative Payment Models (APM), and Performance Based Payments (PBP). Inform the continued development of new and innovative models. Prepare relevant financial summaries, quality measure withholds and incentive calculations, AHCCCS policies, contract and capitation certification language, and public notices.
Prepare State Plan Amendments for outpatient, inpatient, and nursing facility services, along with all required follow-up documentation and actions necessary to obtain CMS approval. Maintain a 100% on-time completion rate for all DAP milestone deliverables, including all ancillary components required to ensure timely and accurate DAP payments.
Support implementation of existing AHCCCS VBP initiatives, including Directed Payments, Alternative Payment Models (APM), and Performance Based Payments (PBP). Inform the continued development of new and innovative models. Prepare relevant financial summaries, quality measure withholds and incentive calculations, AHCCCS policies, and contract and capitation certification language.
Engage and consult with stakeholders, including providers, managed care organizations (MCOs), and agency leaders and clinical staff, to inform VBP strategies. Collaborate with clinical teams to incorporate quality performance measures into financial models and align VBP programs with the AHCCCS Quality Strategy.
Assist with the facilitation of communication with internal and external stakeholders.

Knowledge of:
Data processing principles, concepts and current practices within AHCCCS and the Contractors
Claims/Encounter processing, concepts and industry practices
Appropriate techniques for the analysis of encounter information
Encounter Data methodology and operations
Understanding of contractual requirements, policy and procedures related to the submission and oversight of encounter submissions
Research methodologies
Professional standards, methods, forms and procedures for the reporting of medical claims/encounter information
How data is used in research investigations
Knowledge of Medicaid/Medicare programs and services
Versed in ICD-9, ICD-10, CPT/HCPCS coding and National Drug Codes
Thorough knowledge of computerized Prepaid Medicaid Management Information System (PMMIS) and the Transaction Insight Portal
Skills in:
Word, Access, Excel, Power-point and Outlook
Team and interpersonal skills
Oral and written communication skills, including grammar
Problem solving as it relates to position
Organizational skills
Ability to:
Analyze complex problems and draw logical conclusions based in information from several sources, including plan surveys, and discussions with technical personnel
Determine if criteria meet research needs
Interpret and understand documented medical information of a more complex nature
Express technical information in a clear and concise manner
Calculate basic statistics
Communicate effectively when interacting with persons in a variety of settings, including personnel from Contractors
Obtain cooperation of Contractors and secure acceptance of recommendations
Speak and write effectively
Use various computer software applications

Minimum:
Three years of managing analysis experience appropriate to financial data.
A bachelor's or master's degree in finance or economics will substitute for two years of required experience.
Preferred:
Bachelor's degree in business, economics, finance, health administration, or related field. Experience Medicaid managed health care programs.
Coursework in intermediate level statistics, applied research methodology, accounting/finance, & healthcare medical terminology.

Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency's ability to reasonably accommodate any restrictions.
Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.)

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver's License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

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. Learn more about the Paid Parental Leave pilot program here.
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

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.

Learn more about the Paid Parental Leave program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

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.

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov.
Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.