Primary City/State:

Phoenix, Arizona

Department Name:

HP Statewide Plan Admin

Work Shift:

Day

Job Category:

General Operations

A rewarding career that fits your life. Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, apply today.

Arizona is a year-round destination. Sunny skies and low humidity prevail 300 days a year across the state. From awesome natural wonders to culinary treats, tribal lands, vibrant cities, world-class resorts, renowned golfing and historic Western towns, there are some truly breathtaking moments to be had in the Grand Canyon State.

Familiarity and knowledge of behavioral health systems - outpatient clinics, integrated providers, general mental health/substance use covered services, policies and procedures will be helpful in this role. Access and Medicaid experience around behavioral health is necessary in this position. You will be responsible for outreach and engagement of providers, in person and/or via teams and email, and tracking data and reports. This position is remote, with some light travel throughout central/southern Arizona to provider's offices, along with engaging in community events.

Banner University Health Plans (BUHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care. About Banner Health Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

POSITION SUMMARY

This position works with Banner University Family Care (B-UFC) and is responsible to the day-to-day activities related to physical, behavioral health, and integrated programs for members of the Arizona Health Care Cost Containment System (AHCCCS) Complete Care program. This position serves as a point of contact for information specific to Child and/or Adult members. This role ensures cross-system collaboration and coordination around services and resources that address Social Determinants of Health (SDOH) for AHCCCS Complete Care members. The incumbent ensures programs and resources are organized into a coordinated network and creates meaningful partnerships to support members. The position supports internal teams, providers and stakeholders to addresses cultural and linguistic needs in order to help members achieve identified goals in a variety of settings, including home, school, work and the community.

CORE FUNCTIONS

1. Addresses barriers to delivery of healthcare services and facilitates processes and activities targeted to meet the unique needs of members involved in complex systems, including but not limited to child/adult welfare, justice, developmental disabilities, serious mental illness (SMI) and education.

2. Supports in the system development of efforts that align with the goals of safety, permanency and well being for all AHCCCS Complete Care members.

3. Ensures the availability of high-quality, evidence-based practices designed to support members (and their families when applicable) while promoting individual member and/or positive outcomes. This includes identifying and responding to the needs of community health care needs, individual special healthcare needs, chronic health conditions and partnerships with Centers of Excellence (COE).

4. Promotes effective network adequacy to meet the unique needs of members, including but not limited to coordination with Department of Child Safety (DCS), Child Rehabilitative Services (CRS), Department of Economic Security (DES) and Arizona Department of Education (ADE).

5. Provides guidance and consultation to B-UFC Care Management and other internal departments, related to specific member needs. Member needs may include but are not limited to general mental health, homelessness, justice involved, child welfare involved, opioid addiction, developmentally delayed and/or Autism Spectrum Disorder (ASD).

6. Ensures collaboration and coordination of care with providers and system stakeholders to support the development and implementation of protocols to meet the needs of members across varying levels of acuity.

7. Collaborates with internal Banner departments and external providers, stakeholders and community partners to track and report on key outcome indicators related to contracted AHCCCS deliverables.

8. Serves as a resource and provides leadership by attending meetings, as needed, as a representative to the Complete Care team.

9. Facility and community-based collaboration while remaining within budgetary allowances. Internal customers: B-UFC Executive Management Team and other B-UFC departments, including other Banner Health departments, as needed. External customers: AHCCCS, provider network, stakeholder and community partners, as needed, that align with system initiatives to achieve identified outcomes and meet the needs of members.

MINIMUM QUALIFICATIONS

Knowledge, skills and abilities as normally obtained through the completion of a Bachelor’s degree in Social Work or other relevant field related to supportive services and system development.

Located in Arizona. Moderate experience, typically gained through two to four years relevant experience. Experience in Healthcare, Case/Care Management, Clinical Management, Utilization, Quality Management or Medical Management. Must be able to analyze and solve problems. Ability to communicate effectively, both orally and in writing. Ability to correspond and collaborate with internal departments and external entities. Experience with developing, planning and implementing short and long-range goals.
Must be proficient on a computer (PC) with Microsoft Office products. Ability to work with databases/programs and applications.

PREFERRED QUALIFICATIONS

Experience in Arizona Medicaid (AHCCCS) environment.
Project management experience.

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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