Job Opportunity – Purchased/Referred Care (PRC) Manager

Ak-Chin Indian Community  

Title: Purchased/Referred Care (PRC) Manager

Closing date: 05/19/21 11:59 PM Arizona Time

Under the direct supervision of the Ak-Chin Indian Community Council, the Purchased/Referred Care (PRC) Manager is responsible for the oversight and administration of the PRC program which includes supervision of staff, budget development and accountability, and advocate for all eligible program users.

Examples of duties:

  • Responsible for all PRC program operations, functions and services guided by an adherence to program policies and procedures and manages the program that meet the Ak-Chin Indian Community mission, vision and values.
  • Provides supervision and guidance to all PRC staff including scheduling, performance management, and providing training and opportunities for professional growth.
  • Prepares programmatic, fiscal, and statistical reports and data as requested.
  • Works collaboratively with Tribal leadership and other Tribal/Community entities.
  • Assists with determining provider agreement rates for PRC outpatient and inpatient services.
  • Ensures the processing of Medicare-Like rates for appropriate claims.
  • Develops the annual budget and closely monitors expenditures, variances and high cost/chronic care case management.
  • Provides guidance on day-to-day services including eligibility determination, maintaining billing and payment records, authorizing services, claims processing and identifying alternate resources.
  • Prepares CHEF claims in coordination with the PRC Specialist.
  • Ensures an office culture of respect, enthusiasm to assist program recipients, teamwork and positive attitudes; effectively and efficiently addresses staff and program recipient issues.
  • Maintains strict confidentiality, meets HIPAA compliance and IHS regulatory requirements as well as all other tribal, state or federal applicable regulations.
  • Performs other duties as assigned.
See full job description and apply here.