• Develop, document, and execute comprehensive test plans, test cases, and test scripts to validate Salesforce-based system functionality, workflows, and integrations. • Perform functional, integration, regression, and performance testing to ensure the solution meets stakeholder requirements and federal compliance standards. • Validate data migration from legacy systems, ensuring data accuracy, integrity, and completeness. • Collaborate with developers, business analysts, and stakeholders to understand requirements, user stories, and system workflows to design effective test strategies. • Identify, document, and track defects using tools like Jira, ensuring timely resolution and retesting. • Participate in Agile ceremonies (e.g., sprint planning, daily stand-ups, reviews) to provide quality assurance insights and align testing with sprint goals. • Support user acceptance testing (UAT) and validate training materials to ensure usability and adoption. • Create and maintain QA documentation, including test results, defect reports, and quality metrics, for gate reviews and project deliverables. • Contribute to continuous improvement of testing processes and tools to enhance efficiency and coverage.

• Design, build, and maintain reusable test automation frameworks (integration, E2E, load) that minimize maintenance and maximize reliability. • Leverage AI-assisted development and agentic coding workflows to accelerate test creation and stay ahead of the curve. • Partner with developers to bake automated tests directly into our CI/CD pipelines, ensuring quality is never an afterthought. • Balance automated suites with manual exploratory smoke testing and functional testing to ensure every user story meets our "gold standard" before release. • Identify coverage gaps and proactively propose improvements to reduce system fragility and long-term technical debt. • Support our commitment to users by utilizing SAST/DAST tools for security and Axe/Lighthouse to ensure our products are accessible to everyone. • Guide intermediate and junior engineers on testing best practices and the responsible, efficient use of AI coding tools. • Actively participate in design discussions and Agile ceremonies to advocate for testability, maintainability, and clear acceptance criteria. • Promote a shared responsibility for quality across the entire engineering team, documenting strategies and automation patterns for everyone to use. • Monitor production incidents and operational data to turn real-world "lessons learned" into future quality improvements.

Overview The US Oncology Network is looking for a Revenue Cycle Quality Analyst to join our team at Texas Oncology. This remote position will support the Revenue Cycle Department at our 3001 East President George Bush Highway Suite 100 location in Richardson, Texas. Typical work week is Monday through Friday, 8:00a - 5:00p. Note from Hiring Manager: Join a leader who is intentionally building QA as a profession, not just a function. The approach to QA emphasizes clarity of purpose, psychological safety, and continuous development—creating an environment where analysts are trusted partners and subject‑matter experts, not auditors on the sidelines. TXO Revenue Cycle has made a deliberate investment in building mature, standardized, and governance‑driven quality practices that directly influence patient experience, compliance, and financial integrity Texas Oncology is the largest community oncology provider in the country and has approximately 600+ providers in 220+ sites across Texas and southeastern Oklahoma. Our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today—at Texas Oncology, we use leading-edge technology and research to deliver high-quality, high-touch, evidence-based cancer care to help our patients achieve “More breakthroughs. More victories.” ® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis. Why work for us? Come join our team that is responsible for helping lead Texas Oncology in treating more patient diagnosed with cancer than any other provider in Texas. We offer our employees a competitive benefits package that includes Medical, Dental, Vision, Life Insurance, Short-term and Long-term disability coverage, a generous PTO program, a 401k plan that comes with a company match, a Wellness program that rewards you practicing a healthy lifestyle, and lots of other great perks such as Tuition Reimbursement, an Employee Assistance program and discounts on some of your favorite retailers. Join a Team That Invests in Your Future At Texas Oncology, we recognize the long-term impact of our people and are committed to rewarding performance and potential. That’s why select roles may be eligible to participate in our Long-Term Incentive Plan (LTIP): an incentive program designed to attract, retain, and reward top talent. What is the Long-Term Incentive Plan (LTIP)? Long-Term Incentive Plan (LTIP): is an incentive program that typically vests over a three-year period and is tied to both individual performance and the operational success of Texas Oncology. Awards are discretionary and based on your position, performance, and potential for future career growth at Texas Oncology. Awards are reviewed and approved during the annual compensation review. LTIP awards are subject to your continued employment through the award payment date, and are governed by the written terms and conditions of the LTIP document. What does the position do? Under direct supervision, responsible for supporting quality assurance and continuous improvement that ensures alignment with organizational objectives. This position will be responsible for planning, developing, and facilitating quality assurance activities to evaluate Revenue Cycle processes and procedures. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards, and US Oncology’s Shared Values. Responsibilities The essential duties and responsibilities: - Participates in activities to examine the overall effectiveness, quality, and compliance of revenue cycle processes with company policies and procedures. - Facilitate quality assurance assessments to ensure compliance with company policies and procedures and applicable laws and regulations. - Completes internal quality assurance assessments in accordance with department and company standards and policies. - Detects areas of operational inefficiencies, internal control weaknesses and noncompliance with departmental policies/procedures and applicable laws and regulations. - Gathers data from business systems applications, company documentation, analytical testing, and interviews with personnel and personal observation. - Assesses practice, role, and process-specific procedures to ensure overall adherence to revenue cycle standards and policies. - Evaluates overall audit results by working to review factors causing deficiencies and recommended courses of action prior to issuance of final reports. - Summarizes quality assurance findings and preliminary recommendations for management review. - Drafts written reports in accordance with reporting standards. Ensures all findings, exceptions and proposed adjustments to processes are explained or included in reports. Assists with presentation of reports. - Assists in establishing action plans for assessment findings and follows up to ensure implementation of improvements. - Recommends and documents audit procedures, standard reports and metrics to improve business processes and procedures. - Other duties as requested or assigned. Qualifications The ideal candidate for the position will have the following background and experience: - High School diploma or equivalent required. - Three (3) years of work experience in a related field or equivalent combination of education and work experience. - Excellent interpersonal and presentation skills, both in-person and virtually. - Analytical skills (ability to objectively evaluate data and perform statistical analysis). - Proficiency with Microsoft Office Products (Word, Excel, PowerPoint, and Outlook). - Experience with Lean tools, 5S, 8D, Kaizen events, Six Sigma tools, PFMEA, Control Plans, Process Flow, Process Auditing, ISO, and/or Poka Yoke design is desired. - Must successfully complete the required onboarding courses and training within 45 days of occupying position. Preferred Qualifications: - Bachelor’s degree in a related field. - OR - Associate’s Degree and 2 additional years of realted experience - OR - 8 years of related experience - Prior experience or certification in quality, six sigma, process improvement, or lean. - Knowledge of medical insurance processes, billing, and collections with CPT, ICD10, and HCPCS coding and medical terminology, as well as an overall understanding of managed care products (HMO, PPO, etc.). Competencies The ideal candidate will possess a combination of technical and soft skills essential for success in this role. These competencies ensure the ability to perform job duties effectively and contribute positively to the team and organization. - Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; accesses and uses other expert resources when appropriate. - Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change; shows resilience in the face of constraints, frustrations, or adversity; demonstrates flexibility. - Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. - Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. - Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range. Work Environment: This is a hybrid position. The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology/hematology clinic environment. Work will involve in-person and virtual interaction with co-workers and management and/or clients. Work may require minimal travel by air or automobile to office sites.

AHCCCS Arizona Health Care Cost Containment System Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility. AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry. Come join our dynamic and dedicated team. Quality Assurance Investigative Nurse Office of Inspector General (OIG) Job Location: Address: 150 North 18th Avenue Phoenix, Arizona 85007 All AHCCCS Employees must reside within the state of Arizona. Posting Details: Salary: $75,000 - $85,000 FLSA Status: Exempt Grade: 22 This position will remain open until filled. Job Summary: Under the leadership of the Inspector General and Deputy Assistant Director, this position is responsible for investigation and medical necessity clinical determinations for AHCCCS OIG. These duties include, but are not limited to; investigating, reviewing, evaluating, determining appropriate payment of medical and/or behavioral healthcare services, and medical record reviews with clinical expertise in procedures and processes in the clinical setting. Assurance of compliance with contractual, regulatory, and statutory obligations for AHCCCS members (in both Managed Care Organization (MCO) and Fee for Service (FFS) settings) for physical/acute care services, LTC supports and services, and behavioral health needs and providing subject matter expertise (SME) in a variety of settings. This position is accountable for the prevention and/or resolution of alleged billing concerns, utilization, and determination of any fraudulent activities, waste or abuse of the Medicaid program, identification of criminal activity, and review of system parameters in accordance with AHCCCS rules, regulations and federal guidance. Direct clinical investigative knowledge and expertise is applied by this position in review and timely resolution of the cases assigned, identification of Fraud, Waste and Abuse (FWA) in clinical reviews and collaboration with AHCCCS Divisions, Managed Care Organizations, Law Enforcement Agencies, and other regulatory agencies as identified within the scope of each unique case. Major duties and responsibilities include but are not limited to: • Utilizing clinical knowledge and judgment; conducts complex investigations and performs clinical documentation and evidentiary review of fraud, waste and abuse allegations into medical violations of AHCCCS specific policies and procedures as well as Arizona laws, Statutes, and Federal regulations relating to the AHCCCS programs and care systems. Receive, research, document and resolve cases utilizing standardized processes. To the extent a standardized process does not exist, participate in the creation of a standardized investigation process. Investigations & medical determinations include, but are not limited to: Review CPT coding, level of care, miscoding (including upcoding & unbundling), fraudulent or wasteful billing, incorrect use of services, overutilization, assessment of medical necessity, appropriateness of services, emergency determinations, lengths of stay, services provided within scope of specific clinicians, review of clinically complex members, vulnerable populations, and other items as identified. Reviews medical records and other relevant documentation; conducts investigative interviews and obtains and gathers data to support findings. Collaborates with AHCCCS management at multiple levels and law enforcement regarding findings and recommended actions. • Conduct interviews, participating in surveillance operations, secure evidence, writing complex comprehensive reports, and data analysis. Manage and monitor caseload and timeliness, document actions taken and follow-up actions with case notes. Create and submit high-level reports, extracts, and ad hoc analyses to providers, division management, legal and/or law enforcement staff of the outcome of the investigative and clinical review. Participate in the exchange of information to determine the support of and final outcomes of investigative findings. Supports reviews through the investigative process and hearings if necessary. Ensure these steps occur in compliance of all mandated regulations. • Reviews new/incoming referrals for disposition, referrals to the appropriate agency for actions, collaborate with internal OIG divisions, and performs case prioritization based on severity and escalation factors. • Participates in on-going process improvement, work groups, committees, and other special projects to improve efficiency, strengthen program goals, and detect and eliminate identified FWA. Knowledge, Skills & Abilities (KSAs): Knowledge: • State and Federal Policies and Procedures governing Title XIX, Title XXI, NTXIX, Managed Care, FFS, LTC Supports and Services, Behavioral Health and all AHCCCS programs • Medical/nursing practice, medical case management protocols, utilization review protocols, etc. • Healthcare delivery system nationally and locally • Acute nursing processes including assessment, planning, intervention and evaluation • InterQual or Milliman Criteria, CCI • Coding: CPT, HCPCS, ICD-10 & Medical Claims Review • Understanding of health care delivery systems and mechanisms necessary for coordination and delivery of services • Current standards of medical/behavioral practice and delivery of acute/non-acute medical/behavioral care, Alternative levels of care • In the area of clinical nursing practices, medical terminology, medical procedures, billing and coding • Conducting investigative reviews, techniques, and report writing • AHCCCS policies and procedures, State and Federal statutes, rules and regulations as it applies to the Medicaid program and services covered • Financial considerations for the state • Fraud Waste and Abuse Skills: • Problem solving identification; evaluation and initiation of appropriate actions; nursing assessment reviews • Medical case reviews, case investigations or work of considerable difficulty on complex cases requiring a medical and/or clinical knowledge and background. • Extracting and using information from medical records, documents, and related information to support review and findings • Interviewing and eliciting information in an investigation; and interpersonal relations, as applied to interaction with providers, members, employers, other state agencies; organization, legal entities, and law enforcement • Prioritization, and follow through by tracking documents, responses and correspondence related to the outcome of the investigative review • Written and oral communication to prepare and communicate factual, comprehensive understandable reviews and results • Public relations skills, interacting with statewide providers of healthcare services, public organizations, and law enforcement agencies • Strong interpersonal skills in working with people of diverse culture and socioeconomic backgrounds • Interpretation of rules, laws, and agency policy pertaining to the AHCCCS program Abilities: • Assess members from a holistic perspective with an emphasis on recognizing medical, social, environmental and emotional conditions, barriers for meeting medical needs, assess provider duties and obligations towards rendered member treatments • Read and interpret medical documentation, interpret clinical information and asses implications for treatment • Prioritize, plan, analyze, coordinate, and manage a heavy caseload; maintain objectivity; produce timely and accurate reports and documentation that support findings; present findings to multiple levels of individuals including management, providers, legal, and law enforcement • Review, interpret and apply AHCCCS policies, Federal and State statutes and requirements, and knowledge of hierarchy of each pertaining to services • Effectively work on multiple tasks and varying priorities • Work in both independent and collaborative settings • Gather facts, organize, and comprehend complex medical information to make logical interpretations • Apply clinical knowledge, analytical and problem-solving methods to reviews and determinations of findings • Exercise good judgment in making strategic decisions in investigative reviews and outcomes. • Analytical ability to identify and correlate clinical and investigative patterns, initiate investigations, submit findings • Be productive in a virtual setting Qualifications: Arizona Driver's License. Minimum: • Possession of a license to practice as a registered nurse (RN), Physician’s Assistant (PA) or Nurse Practitioner (NP) in the State of Arizona and three (3) years of relevant experience in healthcare clinical settings. Preferred: • Experience in utilization review, investigative experience, knowledge of criminal, civil, and administrative law, and clinical oversight. 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. • 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.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed. 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). Benefits: 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 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. 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.