Role Description The position is responsible for monitoring, evaluating and approving or denying payment of medical and/or behavioral healthcare services through prospective, concurrent, and retrospective review for the Fee for Service population. The position determines medical necessity based on standards of care, rules, regulations, policies and procedures governing the provision of covered services. The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance. Major duties and responsibilities include but are not limited to: - Collaborates with providers, Tribal and AHCCCS staff regarding care coordination, utilization review, prior authorization, coverage criteria, policies and procedures, workflow, member needs, and other issues. - Evaluates, recommends action, negotiates rates, and provides ongoing monitoring for program policy compliance and reporting of data related to specialty services such as Specialty DME, Exception NF Rates, and Over Institutional Cost services. - Confers with Utilization Review Coordinators from the Peer Review Organization regarding concurrent review of length of stay and appropriateness of services. - Provides education and technical assistance to FFS Providers and Tribal staff as needed, including identification, research and resolution of member specific and provider issues, to improve compliance with AHCCCS requirements, policies, and procedures. - Tracks and/or performs focused reviews for compliance related to utilization management processes and Federal and State Rules and Regulations related to the AHCCCS FFS populations. Maintain documentation files. - Devises and submits system generated reports, extracts, and analyses for unit and division and management. - Participates in process improvement and other special projects, work groups, and committees to improve the efficiency of care coordination, utilization management, and other functions in the Clinical Administration unit. Qualifications - Must maintain a current Arizona medical license (RN or higher) or Arizona Behavioral Health license (Associate or higher) and 3 years of relevant healthcare experience. - Experience in Prior Authorization, Utilization Management, claims review, auditing, or managed care; knowledge of population served preferred. 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. - All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify). 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

• Collaborate with clients to understand business needs, objectives, and technical requirements. • Propose & design tailored backup and recovery architectures & solutions leveraging Cohesity Data Protect. • Lead the deployment, configuration, and optimisation of Cohesity Data Protect environments for clients. • Serve as the escalation point for advanced technical challenges during and post-deployment. • Provide professional and timely technical support and consultation to clients. • Assist in designing and deploying backup strategies for containerized environments. • Partner with internal teams and external stakeholders to align on project goals and deliverables.

• Overseeing the implementation of policies, procedures, and strategies related to problem-solving court data • Data collection, verification, validation, organization, maintenance, and statistical analysis • Presenting qualitative and quantitative data using various software applications • Conducting statistical analyses and developing and maintaining data reporting materials such as manuals, tools, and dictionaries • Providing statistical, analytical, and research support to the Steering Committee on Problem-Solving Courts • Compiling, auditing, and analyzing court data • Preparing detailed reports and offering technical assistance to courts • Responding to data and information requests • Collaborating with judges and court staff

• Development, design, deliver and evaluate safeguarding training including face to face training, webinars and Brainshark’s to embed safeguarding knowledge. • Plan, conduct and summarise robust safeguarding investigations which meet the Safeguarding Threshold. • Support managers in preparing for ASV meetings. • Attend relevant external safeguarding meetings such as ASV, strategy meetings, etc. • Liaise with external agencies such as the police and LADO. • Collaborative critical review of safeguarding incidents to strengthen organisational learning. • Complete Safeguarding audit visits and triangulation visit which provides settings with clear learning and measurable actions. • Application of Coaching skills to aid DSL’s decision making. • Completing the Safeguarding data log accurately and in full. • Analysis of Quality data, Regulatory data and Safeguarding data to lead decision making as to where resource is dedicated. • Responsible For: Cancellation of safeguarding training in exceptional circumstances and categorising incident thresholds to determine level of investigation required.