State of Arizona
Deputy Inspector General
Office of Inspector General (OIG). Job Location: 150 North 18th Avenue, Phoenix, Arizona 85007.
All AHCCCS Employees must reside within the state of Arizona. Posting Details: Salary: $100,000 - $110,000. Grade: 25. FLSA Status: Exempt. This position will remain open until filled.
Job Summary This is a high‑level position that reports directly to the AHCCCS OIG Deputy Assistant Director in the Fraud Support and Recovery Section. The position will act as a liaison between AHCCCS OIG, the Unified Program Integrity Contractor (UPIC), the Recovery Audit Contractor (RAC), Centers for Medicare & Medicaid (CMS) audits, and the Arizona Attorney General’s Office. It will manage the work of the UPIC and the RAC with AHCCCS OIG, act as the contact for AHCCCS OIG CMS audits, manage AHCCCS OIG performance and production metrics for the Inspector General, supervise the OIG Collection team, and manage the AHCCCS OIG collection process.
Major Duties and Responsibilities
Coordinate the UPIC activity, ensure the contractor is performing as required, and communicate the performance, issues, or concerns with the UPIC to the Inspector General and Deputy Assistant Director in the Fraud Recovery and Support Section.
Coordinate the RAC activity, ensure the contractor is performing as required, and communicate the performance, issues, or concerns with the RAC to the Inspector General and Deputy Assistant Director in the Fraud Recovery and Support Section.
Manage the OIG collection process, supervise the OIG Collections team, oversee over‑payments and recoupments returned to AHCCCS OIG, ensure the collection process is followed to accurately reflect payments received and deposited by the AHCCCS Division of Business & Finance (DBF), determine OIG bad debt quarterly, submit bad debt write‑off requests to the Attorney General’s office annually, monitor balance‑due cases assigned to the Collection team, and assist with external audit requests.
Generate the AHCCCS OIG monthly metrics report and charts to illustrate the performance of the OIG and OIG staff, use OIG case management data to highlight division activity on a monthly, annual, and ad‑hoc basis, create charts to visualize the data for the Inspector General, OIG managers, supervisors, and staff, work with all OIG staff, including Lean Champions, to recommend areas of improvement and highlight successes, coordinate CMS audits and requests for information as the AHCCCS OIG contact, and keep the Inspector General informed on CMS audit activities.
Coordinate CMS audits and metric requests for information as the AHCCCS OIG contact, keep the Inspector General and OIG leadership informed of incoming, pending, and finalized CMS requests, and manage the gathering of information required to address CMS requests.
Assist the AHCCCS OIG Deputy Assistant Director and Audit supervisor in the Fraud Support and Recovery section with AHCCCS policy and contract revisions and development, including contract deliverable reviews.
Assist OIG Project Managers with projects and information as needed.
Knowledge, Skills & Abilities (KSAs)
Knowledge:
Federal and state laws, rules and regulations pertaining to State Medicaid and collection of state funds.
Knowledge:
Claims processing, procedures, financing and operations for FFS and MCO.
Knowledge:
Auditing methods and systems of generally accepted auditing standards, risk assessments, contract and fiscal management.
Knowledge:
Thorough knowledge of HIPAA and the rules pertaining to the sharing of investigative information.
Knowledge:
Experience with health care compliance and/or auditing medical billing and coding.
Knowledge:
Principles of strategic planning and performance management.
Knowledge:
Arizona Revised Statutes.
Skills:
Mathematical and computation skills, facilitation.
Skills:
Developing reports to highlight key metrics and trends.
Skills:
Research methodologies, statistical sampling and quality assurance.
Skills:
Creating data visualization tools to help users understand complex data.
Skills:
Investigative methods, techniques, and approaches necessary to plan and conduct criminal, civil and administrative investigations related to the operations and activities of AHCCCS.
Skills:
Extensive financial reporting responsibilities, including weekly/monthly reconciliation, aged balance tracking, bad debt exposure, forecasting and ad‑hoc reporting as needed.
Abilities:
Work effectively with external auditors such as Office of the Attorney General, Auditor General, Accounting, Procurement, United States Attorney’s Office, United States Marshall Services, CMS, and other law enforcement entities.
Abilities:
Collect, analyze, and interpret data from multiple sources.
Abilities:
Communicate effectively at all levels both written and orally.
Abilities:
Work and be productive in a virtual office setting.
Abilities:
Work with a wide variety of stakeholders.
Abilities:
Interpret and apply Federal and State Statutes and Agency policies.
Abilities:
Design/develop and maintain updates to user procedures, job aids, and other supporting training documentation.
Qualifications Arizona Driver's License.
Minimum:
Two years experience as an Auditor Supervisor or Manager or closely related field. Preferred:
Three or more years experience providing direct supervision and overseeing daily activities of a section (or) Degree in Criminal Justice or related field or Certified Fraud Examiner (CFE) Certification, or Certified Professional Coder (CPC) and two or more years of responsible investigative experience preferably in government, healthcare, law enforcement, insurance, or managed care organization.
Pre‑Employment Requirements
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.
Benefits
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.
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.
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.
Contact Us Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.
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Job Summary This is a high‑level position that reports directly to the AHCCCS OIG Deputy Assistant Director in the Fraud Support and Recovery Section. The position will act as a liaison between AHCCCS OIG, the Unified Program Integrity Contractor (UPIC), the Recovery Audit Contractor (RAC), Centers for Medicare & Medicaid (CMS) audits, and the Arizona Attorney General’s Office. It will manage the work of the UPIC and the RAC with AHCCCS OIG, act as the contact for AHCCCS OIG CMS audits, manage AHCCCS OIG performance and production metrics for the Inspector General, supervise the OIG Collection team, and manage the AHCCCS OIG collection process.
Major Duties and Responsibilities
Coordinate the UPIC activity, ensure the contractor is performing as required, and communicate the performance, issues, or concerns with the UPIC to the Inspector General and Deputy Assistant Director in the Fraud Recovery and Support Section.
Coordinate the RAC activity, ensure the contractor is performing as required, and communicate the performance, issues, or concerns with the RAC to the Inspector General and Deputy Assistant Director in the Fraud Recovery and Support Section.
Manage the OIG collection process, supervise the OIG Collections team, oversee over‑payments and recoupments returned to AHCCCS OIG, ensure the collection process is followed to accurately reflect payments received and deposited by the AHCCCS Division of Business & Finance (DBF), determine OIG bad debt quarterly, submit bad debt write‑off requests to the Attorney General’s office annually, monitor balance‑due cases assigned to the Collection team, and assist with external audit requests.
Generate the AHCCCS OIG monthly metrics report and charts to illustrate the performance of the OIG and OIG staff, use OIG case management data to highlight division activity on a monthly, annual, and ad‑hoc basis, create charts to visualize the data for the Inspector General, OIG managers, supervisors, and staff, work with all OIG staff, including Lean Champions, to recommend areas of improvement and highlight successes, coordinate CMS audits and requests for information as the AHCCCS OIG contact, and keep the Inspector General informed on CMS audit activities.
Coordinate CMS audits and metric requests for information as the AHCCCS OIG contact, keep the Inspector General and OIG leadership informed of incoming, pending, and finalized CMS requests, and manage the gathering of information required to address CMS requests.
Assist the AHCCCS OIG Deputy Assistant Director and Audit supervisor in the Fraud Support and Recovery section with AHCCCS policy and contract revisions and development, including contract deliverable reviews.
Assist OIG Project Managers with projects and information as needed.
Knowledge, Skills & Abilities (KSAs)
Knowledge:
Federal and state laws, rules and regulations pertaining to State Medicaid and collection of state funds.
Knowledge:
Claims processing, procedures, financing and operations for FFS and MCO.
Knowledge:
Auditing methods and systems of generally accepted auditing standards, risk assessments, contract and fiscal management.
Knowledge:
Thorough knowledge of HIPAA and the rules pertaining to the sharing of investigative information.
Knowledge:
Experience with health care compliance and/or auditing medical billing and coding.
Knowledge:
Principles of strategic planning and performance management.
Knowledge:
Arizona Revised Statutes.
Skills:
Mathematical and computation skills, facilitation.
Skills:
Developing reports to highlight key metrics and trends.
Skills:
Research methodologies, statistical sampling and quality assurance.
Skills:
Creating data visualization tools to help users understand complex data.
Skills:
Investigative methods, techniques, and approaches necessary to plan and conduct criminal, civil and administrative investigations related to the operations and activities of AHCCCS.
Skills:
Extensive financial reporting responsibilities, including weekly/monthly reconciliation, aged balance tracking, bad debt exposure, forecasting and ad‑hoc reporting as needed.
Abilities:
Work effectively with external auditors such as Office of the Attorney General, Auditor General, Accounting, Procurement, United States Attorney’s Office, United States Marshall Services, CMS, and other law enforcement entities.
Abilities:
Collect, analyze, and interpret data from multiple sources.
Abilities:
Communicate effectively at all levels both written and orally.
Abilities:
Work and be productive in a virtual office setting.
Abilities:
Work with a wide variety of stakeholders.
Abilities:
Interpret and apply Federal and State Statutes and Agency policies.
Abilities:
Design/develop and maintain updates to user procedures, job aids, and other supporting training documentation.
Qualifications Arizona Driver's License.
Minimum:
Two years experience as an Auditor Supervisor or Manager or closely related field. Preferred:
Three or more years experience providing direct supervision and overseeing daily activities of a section (or) Degree in Criminal Justice or related field or Certified Fraud Examiner (CFE) Certification, or Certified Professional Coder (CPC) and two or more years of responsible investigative experience preferably in government, healthcare, law enforcement, insurance, or managed care organization.
Pre‑Employment Requirements
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.
Benefits
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.
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.
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.
Contact Us Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.
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