Role Description This position is responsible for independently reviewing and analyzing clinical medical review decisions, identifying patterns of variability and opportunities for improvement as well as developing reference materials and training resources to support consistent and standardized application. Essential Responsibilities - Quality Review (50%): - Develops a process for and conducts independent, accurate and timely inspection of clinical decisions to evaluate clinical review determinations. - Analyzes the results of the quality checks, prepares reports of findings and works with the respective management if remedial training is needed. Conducts follow-up quality and inter-rater reviews as needed for identification of areas for improvement or ongoing interventions. - Leads, develops, and manages clinical quality improvement, including meeting planning and facilitation, recording of quality meeting minutes, assignment of follow-up tasks, and preparing reports and summaries. Collaborates with management, other departments and the Contractor Medical Directors (CMDs) to identify clinical areas of focus and indicators for regular monitoring or quarterly Inter-Rater Reliability. - Research & Analysis (25%): - Maintains detailed knowledge and understanding of federal and state regulatory review requirements as well as local and national policy to ensure clinical quality improvement initiatives are following standards and requirements. - Provides clinical research and support to the CERT Team. - Research and answer clinical review questions, as needed. - Participates in provider education when requested. - Training & Development (15%): - On a monthly basis, provides input and/or participates in a strategic planning session to evaluate various data elements to identify new or continued areas of focus for clinical quality improvement initiatives in order to meet CMS requirements. Works with CMDs to interpret clinical practice guidelines based on review of the current scientific literature for areas of focus, as needed. - Works collaboratively with management to ensure the guidelines are disseminated to team and/or providers. - Provides feedback regarding performance and develops/initiates corrective actions for areas identified as needing improvement. - Coordinates and produces quarterly Inter-Rater Reliability assessments. - Reporting & Outcomes (10%): - Prepares and distributes quality reports and intervention plans with management for input and feedback/direction. - Reports monthly quality scores for inclusion in the QMR reports. - Reports quarterly Inter-Rater Reliability scores. - Recommends process improvements designed to improve accuracy, timeliness of processing and/or eliminate manual effort. Qualifications - High School diploma or GED - 3 years' related work experience with a minimum of 2 years' clinical experience - Computer literacy - Working knowledge of Microsoft Office software (Word, Excel, Access, PowerPoint, etc.) - Knowledge of Medicare policy, guidelines, regulations, protocols, and local and national coverage determinations - Strong analytical, problem solving and communication skills Requirements - Valid unrestricted Registered Nurse (RN) license Preferred Qualifications - Bachelor of Science in Nursing (BSN) - 5-7 years of clinical experience - 5 years' experience in the insurance industry with that time in a clinical decision-making setting - Experience developing and running process improvement initiatives, skilled in project planning and able to work within tight time frames, utilizing both internal and external resources - Operational knowledge of relevant Medicare processes - Ability to understand and evaluate numerical data, tables, charts or graphs; perform calculations, make comparisons and combine quantitative information - Strong presentation skills - Experience with committee facilitation Certifications, Licenses, Registrations - CPC (Certified Professional Coder) Background Investigation If you are selected for this position, you must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing documentation must be cleared prior to hire. Most positions are subject to additional Identity Proofing, Fingerprinting and additional Background Investigation screening conducted by the Federal Government to be granted Enterprise User Administration (EUA) system logical access after you begin your employment. Your continued employment is contingent upon the outcome of the complete additional screening criteria required for the position which must find that you meet the applicable government customer's requirements (e.g., suitable for access to CMS information and information systems), as well as any additional investigation which may be required throughout your employment. If you are found not suitable, your employment may be subject to corrective action, up to and including immediate termination of employment. Identity Documentation You must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents. Note: Employment Authorization Cards (EAD) are not a substitute for Visas or U.S. Permanent Resident Cards. Benefits - Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire - Short- and long-term disability benefits - 401(k) plan with company match and immediate vesting - Free telehealth benefits - Free gym memberships - Employee Incentive Plan - Employee Assistance Program - Rewards and Recognition Programs - Paid Time Off and Paid Sick Leave Company Description We are an Equal Opportunity/Protected Veteran/Disabled Employer. This opportunity is open to remote work in the following approved states: AL, AR, FL, GA, ID, IN, IO, KS, KY, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require further approval. In FL and PA in-office and hybrid work may also be available.

Role Description Working with the Low Code & AI team to consult on, you will be responsible for designing, developing and implementing Low Code & Agentic solutions, using the Power Platform, in an Agile Approach to Project delivery. Responsibilities - Customer Engagement - Collaborate closely with customer to understand their business requirements, challenges, and objectives, right down to the individual task level requirement. - Conduct workshops and discovery sessions to gather detailed requirements and define project scope. - Build strong relationships with customers, acting as a trusted advisor on Power Platform & AI-driven solutions. - Ability to understand the customer’s business problem that needs solving and drive the discussion around the business value that any solution would provide. - Demonstrate several full project lifecycles of Power Platform & AI-driven solutions that have been delivered from Project Intake and requirements to productionised solution. - Solution Design & Development - Ability to lead with solutions which should be Low Code & AI focused and avoid technical debt where possible. - Design innovative and scalable solutions using Power Apps (canvas, model-driven, Code Apps, Power Automate, Power Pages, Copilot Studio and Power BI to address client needs. - Develop custom applications, workflows, and reports within the Power Platform environment. - Configure and customise Microsoft Dataverse to support application data requirements and effectively demonstrate effective data modelling skills. - Knowledge of the wider Power Platform around ALM, CI/CD Pipelines, Source Control, Environment Management, Data Loss Prevention and Security is desired. - Integrate Power Platform & AI-driven solutions with other Microsoft technologies. - Documentation of solutions and design thinking that can be passed for ongoing solution support once in production. - Project Management - Proficient in delivering solutions using agile methodologies such as Scrum or DSDM. - Demonstrate working in a timeboxed working environment and how to successfully manage customers requirements within a specific time period. - Proficient in managing project backlog using ADO or other suitable tools. - Manage project timelines, milestones, and deliverables to ensure successful project completion. - Work closely with project teams, including solution architects, developers, testers, and stakeholders to drive project progress and resolve issues. - Provide regular updates to clients and internal stakeholders on project status, risks and dependencies. - Ability to successfully manage and estimate project backlog and scope for specific agile iterations. - Training & Support - Provide training and knowledge transfer sessions to clients to empower them to effectively use and maintain Power Platform & AI-driven solutions. - Provide training and knowledge transfer session to clients to empower them on agile delivery methodologies and project standards such as how to write effective user stories or managing project backlogs and the role of the customers Product Owner. - Offer ongoing support and troubleshooting assistance to clients post implementation. - Shows a deep Systematic Learning approach to stay up to date with the latest features and capabilities of the Power Platform and related Microsoft technologies. - Awareness of the importance of Organisational Change Management behaviours to drive adoption and ability for customers to track their key KPI’s against adoption and enablement. - Be able to confidently deliver Microsoft’s ‘In-a-day’ workshops and ANS-organised customer events (such as hackathons). Qualifications - Excellent communication skills both with customers and internal teams. - Proven experience designing and developing solutions using Power Apps, Copilot Studio, Power Automate and Power BI. - Strong understanding of Microsoft Dataverse and Data Modelling Concepts. - Good understanding of other data storing options, such as Azure SQL, SharePoint. - Understanding of Microsoft Foundry, Azure AI Search, Function apps advantageous. - Confidence in challenging customer requirements and offering elegant workarounds. - Demonstrable passion and talent for user interface and user experience design. - Experience in applying design thinking concepts and techniques to capture customer requirements effectively and collaboratively. - Proficient in agile methodologies. - Confidence and experience running Hackathons / Live Build sessions with customers to showcase Power Apps solutions and the building process. - Self-motivated to continue to learn, upskill and stay up-to-date with the ever changing Microsoft Power Platform & Agentic AI. - Ability to work independently and as part of a collaborative team. - Strong problem solving and analytical abilities. - Adhere to information security through business policies and procedures. Benefits - 25 days’ holiday, plus you can buy up to 5 more days. - Your birthday off, and an extra celebration day for whatever you want. - 5 days’ additional holiday in the year you get married. - 5 volunteer days. - Private health insurance. - Pension contribution match and 4 x life assurance. - Flexible working and work from anywhere for up to 30 days per year (some exceptions). - Maternity: 16 weeks’ full pay, Paternity: 3 weeks’ full pay, Adoption: 16 weeks’ full pay. - Company social events – get ready for a jam-packed calendar. - Electric car scheme. - 12 days of personal growth development time.

• Build and drive the SC function from the ground up to world-class competition level • Serve as DualEntry’s lead solutions consultant in sales conversations, translating complex finance and accounting workflows into clear product solutions • Run product demos tailored to each prospect’s workflows, data, and success criteria (expertise in ASC 606 is a plus) • Own technical discovery and remove technical objections across integrations, data migration, security, reporting and future functionality • Build proof-of-concepts and demo environments for different verticals we sell into • Partner with Product and Engineering to prioritize the roadmap with customer insights • Create and standardize demo assets, playbooks, and technical collateral to scale the Solutions function and train future hires

• Act as a trusted advisor to senior client stakeholders • Lead multi‑disciplinary teams • Take ownership of programme delivery from discovery through to closure • Help shape Civiteq’s methodologies • Develop our people • Identify opportunities to grow client relationships