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. Benefits 10 paid holidays per year Paid Vacation and Sick time off (13 and 12 days per year respectively) – start earning them 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 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 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) #J-18808-Ljbffr