Audit Manager

The Audit Manager will report to the Inspector General. This position is responsible for the direct oversight of the Quality Assurance Nurse Investigations Unit as a highly skilled Registered Nurse with Utilization Review (UR) experience. This individual will provide assistance and guidance to subordinates, as well as, executive management, and support the Inspector General (IG) efforts on a variety of administrative and management issues, projects and initiatives, data analytics, related to investigations of healthcare fraud and program mismanagement.

Salary

• $100,000 - $110,000

Qualifications

Knowledge, Skills & Abilities (KSAs)

Knowledge:
• Clinical record review and healthcare data analysis
• Investigative techniques, interviewing, and evidence evaluation
• Regulatory compliance, audit processes, and defensible case development
• Medicaid/Medicare (Title 19) and AHCCCS rules and provider/member eligibility
• Federal and Arizona laws (ARS Titles 13 & 36) and administrative law
• Healthcare laws, regulations, and standards
• Public assistance program eligibility (SSI, SSD, TANF, LTC, SOBRA)
• Data analysis, spreadsheet development, and system data extraction (AHCCCS/DES)
• Financial and accounting principles for audits and fraud detection
• Organizational leadership, staff development, and performance management
• State personnel rules, EEO, ADA, and workplace compliance

Skills:
• Leadership, supervision, and staff development
• Clinical review and advanced data analysis
• Data management, reporting, and Excel proficiency
• Investigative documentation and report writing
• Medical necessity and standards of care evaluation
• Process improvement and performance metrics (LEAN)Strong communication and collaboration skills
• Strategic support and operational oversight (including site visits)

Abilities:
• Lead, motivate, and develop high-performing teams
• Communicate clear expectations and align staff across functions
• Exercise sound judgment and decision-making under pressure
• Analyze, interpret, and synthesize complex data
• Manage competing priorities and make balanced decisions
• Apply clinical and investigative methodologies consistently
• Build cohesive teams and foster positive workplace culture
• Demonstrate integrity, accountability, and professionalism
• Present findings effectively in formal settings (including testimony)
• Integrate clinical knowledge into investigative processes
• Align work with organizational mission and strategic goals
• Collaborate with leadership and cross-functional teams
• Apply continuous improvement practices (LEAN, AMS, performance metrics)

Other Information

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).

How to Apply

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.

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.