Job: Senior Compliance Officer(Job Id 35178)

This posting has expired and is no longer available.

Job Description

01/09/2018 01/20/2018
PHOENIX 33,435.00-43,893.00

Department of Economic Security

Providing Opportunity, Assistance and Care for Arizonans in need!

Senior Compliance Officer

Division of Developmental Disabilities

1812 West Monroe Street

Phoenix, AZ 85007


The Division of Disabilities (DDD) is seeking highly motivated individual to join our teams as a Senior Compliance Officer. This position focuses on compliance issues related to fraud, waste, and abuse and any duties delegated to Administrative Services Subcontractors (AdSS) related to fraud, waste, and abuse.  The position works closely with Division colleagues throughout the state.


-          Designs, develops, implements, and evaluates audit tools and procedures to monitor standards consistent with the Arizona Health Care Cost Containment System (AHCCCS) Operational Review (OR), AHCCCS contract and Division policies as well as makes recommendations for additional compliance activities. Ensures inter-rater reliability of audit tools.

-          Provides technical assistance to Division staff and subcontracted entities regarding a variety of Arizona Long Term Care System (ALTCS)/AHCCCS (Medicaid) requirements, including  but not limited to: ALTCS, targeted support coordination, cost effectiveness, managed risk agreements, out-of-state placement, electronic member change reports, service utilization (over/under utilization), timeliness, and Medicare.

-          Organize and coordinate communication and activities for the Division and Districts for the purpose of identifying, resolving, and monitoring issues. Drafts written documents, reports, and responses to issues, as necessary.  Reviews and makes recommendations on behalf of the Division regarding health plan requests related to AHCCCS policies for member information, marketing, & advertising.

-          Analyzes, tracks and trends data obtained from various auditing activities. Ensures root causes are identified for any standard not in compliance. Reviews corrective action plans and meets business writing standards. Verifies performance and systems issues are reviewed and follow-up occurs. Monitors implementation of the Division, District and AdSS corrective action plans. Provides technical assistance to Division and AdSS staff in improving compliance with regard to AHCCCS and Division standards. Gathers, tracks & obtains updates from responsible parties regarding issues elevated to the Compliance Unit. Makes recommendations to member's planning teams & Division/District staff that are consistent with AHCCCS and Division standards and are person-centered.  Manages compliance activities as assigned. 



Knowledge of:

-          Managed care principles and delivery systems and acute and long-term care principles.

-          Arizona Health Care Cost Containment System (AHCCCS) statutes, rules, policies, and contract requirements and federal Medicaid regulations.

-          Division of Developmental Disabilities statutes, rules, policies, procedures, and guidelines and the Health Insurance Portability and Accountability Act (HIPAA).

-          Program designs for individuals with developmental disabilities and the organizational relationship of the Division to member/families, AdSS, subcontracted provider network and service provision.

Skill in:

-          Oral and written communication, planning, organizing, prioritizing, and time management.

-          Applying critical thinking techniques towards researching, analyzing, and problem solving.

-          Interviewing and eliciting information in support of project objectives utilizing interpersonal relations and providing leadership.

-          Program planning and evaluation as related to compliance development in conjunction with utilizing computer systems and programs (Microsoft Word, Outlook, Excel, Access, Power Point, AHCCCS/PMMIS system, FOCUS, CATS or similar programs).

Ability to:

-          Relate in a positive and cooperative manner with a wide variety of people and provide recommendations specific to information presented.

-          Work in a fast-paced environment with shifting priorities and remain flexible while ensuring compliance with standards.

-          Problem solve and apply lessons to a broad array of situations, quality control work products, plan, coordinate, and establish priorities, and use independent judgment and work independently.

-          Think through problem situations and manage difficult situations while maintaining confidentiality and professionalism at all times and through all work and be organized.


-          The preferred candidate will have a Bachelor's Degree in Psychology, Social Work or closely related field plus 2 years of experience in health care, compliance, support coordination (case management) or service delivery with individuals with developmental disabilities; OR a Master's Degree in Psychology, Social Work or closely related field plus 1 year of experience noted above.


-          Valid Driver’s License.

-          Background and Reference Checks


 The Department of Economic Security offers a comprehensive benefits package to include: 

-          Sick leave

-          Vacation with 10 paid holidays per year

-          Health and dental insurance

-          Retirement plan

-          Life insurance and long-term disability insurance

-          Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance


Positions in this classification participate in the Arizona State Retirement System (ASRS). 

Please note, enrollment eligibility will become effective after 27 weeks of employment.


If you have any questions please feel free to contact 602-542-6883 for assistance.

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-364-3981. 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.