Information Technology Position Description For assistance completing this form, contact your supervisor/manager or your (HR) Office. Complete form, obtain all signatures, scan and save using the following naming convention: [Agency/Institution]_IT_[Position Number]_[Date: YYYYMMDD]. Example: DSHS_IT_0480_20150621. Position Information Agency/HE Institution, Division, Unit Action Department of Health, Health Technology Solutions, Establish Solutions Design & Project Support Class Code and Title Current Salary Range Enter text. Enter text. Proposed Class Code and Title Proposed Salary Range 483BA - IT Analyst & Software Quality 05IT Assurance Tester (Project) (Journey) Agency/HE Institution Position Number HRMS Position Number (if applicable) NEW 71081443 Project Title (if applicable) Assignment Pay HTS COVID 19 Hiring Dual Language ☐ Other ☐ Enter text. Incumbent’s Name (If filled position) Address Where Position Is Located (Duty Station) Enter text Tumwater, WA Work Schedule HR Approved Overtime Eligible Part Time ☐ Full Time ☒ Yes ☐ No ☒ Position represented by a Master Agreement: Position has an approved In-Training Plan: Yes ☐ No ☒ Yes ☒ No ☐ If yes, attach Position Description for each In-Training Level If yes, list Master Agreement: WFSE Supervisor’s/Manager’s Name and Title Supervisor’s/Manager’s Phone KyLynn Decker, IT Business Analyst & QA Test 360-236-4442 Supervisor Date Completed Date Previous Position Description Approved 4/7/2021 Enter a date. Primary Job Family (select one) Secondary Job Family (select one, if applicable) 3. IT 12. Quality Assurance (Attach an organizational chart.) Summarize the functions of the position’s division/unit and how this position fits into the organizational structure. Health Technology Solutions (HTS) is the central within the Department of Health (DOH) that serves the Information Technology (IT) needs of almost 1,800 employees and 400 IT systems of four program divisions – Environmental Public Health, Disease Control and Health (DCHS), Health Systems Quality Assurance (PCH), Prevention and Community Health – plus Agency Wide Operations (AWO). HTS is led by the DOH Chief Information Officer (CIO) who reports to the Chief of Staff.

The Office of Solution Design & Project Support (SDPS) is one of five major offices within HTS consisting of a team of IT Business Liaisons, a Project Office (PMO) and Business Services Section (BSS). The BSS connects agency programs with IT solutions through the work of business analysts who identify requirements and testers who validate those requirements are met.

This position is an IT Business Analyst & Software Quality Assurance Tester assigned to project work supporting enterprise applications within the Business Services Section of the Solution Design and Project Support Office of DOH’s

OFM 12-082 (3/31/17) Information Technology Position Description Page 1 Health Technology Solutions (HTS). This position reports directly to the IT Business Analyst & Software Quality Assurance Test Supervisor. Position Objective Describe the main purpose of the position and the type and nature of the work performed. This position is part of a team that is responsible for the implementation and management of various systems and the data that supports the Department of Health and Statewide response to the COVID-19 pandemic. The impact of these systems and the data supported is across the department, across the state and at the federal level. Impact is to the general public, Local Health Jurisdictions, laboratories, hospitals, clinics and the Centers for Disease Control and Prevention. The team will be working with various vendors and other state agencies as necessary to support this work.

This position independently provides IT Business Analysis and Quality Assurance Testing skills to ensure the successful accomplishment of the agency’s mission by providing technical leadership, business and data analysis, software requirements management, software testing and engineering for enterprise systems and Covid19 projects.

This position provides mentorship to business and technical analysts and testers. As a fully competent professional, works with stakeholders and technical staff, elicit, analyze, communicate, document, test and validate software requirements to support the agency’s mission.

This position supports the Department of Health’s mission to “Protect and Improve the Health of people in Washington State” by:

• Providing professional level IT Business analysis and Quality Assurance testing, technical knowledge and consultation to IT Business Analysts, IT Project Managers, Quality Assurance Testers, Developers, System Configuration Administrators and Database Administrators. • Ensuring business requirement elicitation, analysis and documentation standards are met. Ensures industry standard business analysis and testing methods are applied to systems to instill confidence with our business customers that the systems supported are of the highest level of accuracy and quality. • Serves as a contributing team member with stakeholders and technical staff, tests and validates software requirements to support the agency’s mission.

Assigned Work Activities (Duties and Tasks) Describe the duties and tasks, and underline the essential functions. Task statements should describe the action performed; to whom or what; using what tools, equipment, methods, and/or processes; and the final product or outcome.

For more guidance, see Essential Functions Guide and Examples of Work Statements List the assigned work in order of importance including the final product or outcome for each, with essential functions underlined. Duty: Provides independent professional level business analysis services Responsible for business analysis, technical analysis and definition of complex automated systems whether done individually or leading a team to complete the work Tasks include: • Serves as liaison between business stakeholders and technical staff to ensure business needs are clearly defined, understood and documented using industry standard requirements documentation methods. • Elicits, plans, analyzes and develops business and/or technical requirements. Ensure requirements are traceable, concise, and accurate and maintained in a common repository. • Leads and/or facilitates the gathering of requirements through interviews, workshops, consultations, site visits, surveys and business process workflows. • Validates and verifies business requirements for new software applications and/or modifications to existing software are mapped to business needs and approved by business stakeholders. • Provides cost estimates based on initial scoping of a business change, refinement of estimates needed and then refinement of estimates as business requirements are completed. These estimates are used to define overall costs of projects and work efforts to support business needs. OFM 12-082 (3/31/17) Information Technology Position Description Page 2 • Works collaboratively with other technical staff to: design user interfaces and system functionality, ensure changes, modifications and/or maintenance and operation schedules are followed, supported and appropriately identified in standard practices that supports standard system/software development life cycle. • Performs analysis of data structures to determine dependencies and relationships between data elements using Entity Relationship Diagrams. • Works collaboratively with other technical staff to identify system performance issues, prototyping of technology solutions to create preliminary user interface options for business stakeholders using a working understanding of web development design and technologies. • Leads and/or participates in cost/benefit analysis of proposed solutions providing business stakeholders with recommended options. • Defines acceptance criteria for technology solutions that support business needs through technical analysis of business requirements, vendor statement of work, and/or other system requirements. • Provides expert level guidance to IT business analysts and testers on standard system/software development lifecycle processes, standard requirement documentation, cost estimate review and tools. Expected Outcomes: Business and functional requirements, cost/benefit documentation, business process models and estimate documentation are complete and allow for development or procurement of systems that meet business needs. Duty: Provides independent software testing services Responsible for testing software and assuring accurate functioning of complex software applications whether done individually or leading teams to complete the work Tasks include: • Develops, reviews and implements test plans, test cases, test reports and testing schedules for software implementations and maintains a test repository. • Identifies and determines the variance between expected and actual results of defect finding based on software requirements to ensure traceability of requirements. • Reviews, verifies and validates software meets technical specifications and business/functional requirements. • Develops command procedures and SQL scripts to identify defect findings such as data errors and/or system anomalies. • Ensures management and senior executives are kept apprised of testing, issues and concerns. • Participates with SDPS management in problem solving, trend analysis, data discovery and reporting to resolve IT system problems for mission critical business applications. • Formulates, develops and implements software testing strategies for testing information systems. • Ensures coordination and collaboration between business and information technology staff for all testing activities during every stage of the testing process.

Expected Outcome Quality systems are implemented into the production environment without major errors or need for rework. Business rules and security and technical requirements are validated to ensure the integrity and stability of the systems.

Duty: Provides independent maintenance and operational support for complex and mission critical systems. Responsible for maintaining support of complex software applications whether done individually or leading teams to complete the work Tasks include: • Coordinates with technology staff across functional disciplines and business programs to develop and plan for the configuration, implementation and training for new releases and upgrades of mission critical information technology systems. • Participates in routine maintenance activities to keep systems current with technology and vendor upgrades or Hot-Fixes. • Provides information to IT and business stakeholders that may assist the organization to improve performance, data quality, system performance, and usability related to applications, interfaces, datasets and databases. • Determines and completes service requests, identifies reuse of existing resources, and coordinates with business analysts and developers to establish priorities for completion. • Identifies and reports IT risks to IT management and project managers; analyzing risks and recommending mitigations and resolutions. • Manages workload by prioritizing and tracking maintenance and operational service requests completion within specified timeframes. OFM 12-082 (3/31/17) Information Technology Position Description Page 3 • Works collaboratively with other technical staff to ensure changes, modifications and/or maintenance and operation schedules are followed, supported and appropriately identified in standard change management practices that supports standard system/software development life cycle. • Assists with emergency response activities as assigned during a public health emergency. • Performs analysis of data structures to determine dependencies and relationships between data elements using Entity Relationship Diagrams and evaluating stored procedures, database functions, triggers or programming code to accomplish correction of data within systems.

Expected Outcome Agency and division systems are operating at their optimal level. Each division’s maintenance and operation repository includes standard documentation of tests, fixes, upgrades, and releases. Standard maintenance of test environments are available for use.

Problem Solving What are the most complex and/or challenging issues addressed by this position? Give 3 to 4 examples and how each is resolved. Complex/Challenging Issue How Resolved Frequency Resolves complex and routine Relies on experience and knowledge to On-going problems requiring analysis and determine the best practice that fits the selection of the best method/process situation and will efficiently resolve the available. problem. Elicitation, analysis and Leads and/or facilitates workshops and On-going documentation of business conducts interviews with business requirements that translate into stakeholders to develop business design specifications and functioning requirements. Ensures business software that meets business needs. requirements are traceable, concise, and accurate. Ensures the translation of those business needs are documented in standard business and/or functional requirements, approved and clearly understood by all business and technical stakeholders. Ensures all documentation is maintained in a common repository to support standard system/software development lifecycle methodologies. Liaison between customers and Meet with diverse stakeholder groups to On-going technical staff to ensure business identify business needs, business rules needs are met with technology and/or policies, document and review solutions. business requirements to ensure business needs are accurately articulated from a business perspective. Translate business needs into functional and/or non-functional requirements, design documentation and specifications to be reviewed with technical team so that development and/or configuration can be completed to meet those needs. Provide software quality assurance Follow testing standards and methods to On-going for agency wide mission critical instill confidence in the system by ensuring agency IT Systems. IT professional staff conducts quality assurance testing to the highest level of accuracy and quality. Develops, reviews and implements test plans, test cases, test reports and testing schedules for software implementations.

OFM 12-082 (3/31/17) Information Technology Position Description Page 4 Reviews, verifies and validates software meets technical specifications and business/functional requirements. Provide maintenance and operational Coordinate with technology staff across On-going support for agency wide mission functional disciplines and business critical agency IT Systems programs to develop and plan for the configuration, implementation and training for new releases and upgrades. Determines and completes routine service requests, identifies reuse of existing resources, and coordinate with business analysts and developers to establish priorities for completion. Decision Making What duties are performed that require the position to make choices, determinations or judgments? This position has the authority to make independent decisions to balance workload and determine what work is the highest priority. Within the scope of operational goals and plans, develops objectives and procedures for enterprise systems. This position keeps supervisor informed of timeline and/or process changes but has ultimate control of standard business processes pertaining to business requirement and testing management within standard software/system development lifecycle. This position recommends process improvements to the Supervisor. Which decisions are sent to the next level of supervisor/manager or technical authority for recommendation/decision? Decisions that require significant changes and/or complex problems that have impact on other team members and/or sets precedence for direction agency. Potential Impact of Results Describe the potential impact of error (What potentially could happen in the event that the individual were to fail to perform their job correctly?). List who (citizens, other department/unit personnel, statewide-personnel, etc.) would be impacted and the degree of impact. This position conducts Business Analysis and Quality Assurance testing for division-wide/enterprise systems and projects. This includes the mission critical systems that support the Public Health Lab, Laboratory System. List what (dollars, larger systems, processes, other resources, etc.) would be impacted and the degree of impact. Failure to capture complete and accurate requirements would result in rework which would increase projects costs and extend project timelines. Failure to provide the support for these projects could result in monetary loss and credibility to the agency.

Financial Dimensions (if applicable) Describe the type and annual amount of all monies that the position directly controls, administers or manages (excluding employee salary and benefits) for example: delegated signature authority amount, invoice approval for expenditures. N/A Lead Work/Supervisory Responsibilities Lead Position: Yes ☐ No ☒ ☐ Assigns Work ☐ Instructs Work ☐ Checks Others’ Work Supervisory Position: Yes ☐ No ☒ ☐ Plans work ☐ Evaluates Performance ☐*Takes Corrective Action ☐*Hires ☐*Terminates (*Has the authority to effectively recommend these actions.) List Class Title and Working Title of Position(s) Supervised If Part Time, What % Part Time %. Part Time %. Part Time %. OFM 12-082 (3/31/17) Information Technology Position Description Page 5 Part Time %. Part Time %. Part Time %. Add information that clarifies this position’s lead or supervisory responsibilities.

Working Relationships Level of Supervision received (check one). For more guidance see Glossary of Classification Terms. ☐ Direct/Close Supervision: Most work is reviewed in progress and upon completion. ☐ General Supervision: Completed work is spot checked. ☒ General Direction: Completed work is reviewed for effectiveness and expected results. ☐ Administrative Direction: Completed work is reviewed for compliance with budget, policies, laws and program goals. Add information that clarifies this position’s interactions with others to accomplish work. Work is assigned primarily by the Business Analysis and Software Quality Assurance Test Supervisor. Specific requests for consulting expertise may also come from peer positions within HTS and program staff.

This position is accountable for the accuracy in business requirements analysis, recommendations on regulatory changes, estimations of level of effort, quality testing standards and processes.

Major enhancements or bug fixes to existing systems are coordinated with the program specific supervisor for prioritization and developer resource assignment. This position interacts with agency managers, supervisors, staff, project managers, program staff, technicians and contractors providing technical services to the agency. Continuity of Operations Plans (COOP) Designation – For Disaster or Emergency Recovery For more information see COOP and Critical Positions. For higher education, refer to your list of essential personnel. Is this position designated critical based on agency COOP? Yes ☐ No ☒ If yes, describe how this position supports the agency COOP Critical Functions.

Qualification – Knowledge, Skills and Abilities Required Education, Experience or Certifications Application (why each qualification exists) A Bachelor’s degree or higher in IT program or a closely This position requires experience and/or education in an IT related fields such as Computer Science, Management environment so that appropriate decisions and considerations Information Systems, Information Technology are taken into account when managing and maintaining our Informatics; and four (4) years (full-time equivalent) of IT systems. Having the education and/or experience allows professional experience in one or more of the following for decisions to be made with a background in this area. IT disciplines: business analysis, testing, or systems

development. Additional years of experience can substitute for education on a one for one basis. This position performs highly complex assignments that OR require experience and education to analyze and implement. An Associate’s degree or higher in Information Technology program or a closely related fields such as Computer Science, Management Information Systems, Information Technology or Informatics; and six (6) years (full-time equivalent) of professional experience in one or more of the following IT disciplines: business analysis, testing, or systems development. Additional years of experience can substitute for education on a one for one basis. OR Eight (8) years (full-time equivalent) of professional experience in one or more of the following IT disciplines: business analysis, testing, or systems development. Of those 8 years the following must apply:

OFM 12-082 (3/31/17) Information Technology Position Description Page 6 • Four (4) or more years (full-time equivalent) experience as a business analyst. • Two (2) or more years (full-time equivalent) of professional experience as a Software Analyst, Quality Assurance Tester or Software Developer. Experience in software development processes eliciting This position is an expert level with specific knowledge of user requirements, analyzing and formally documenting standard software and system development lifecycle business needs, processes and workflows, and using methods. Having this experience provides the knowledge to defined formats for functional use cases and business ensure standard processes and requirement methods are rules. met. Experience preparing documentation including internal This position specifically requires expert level knowledge in technical documents, system diagrams, use cases, test the tools utilized to perform job duties. These tools are cases, and user documentation and manuals. necessary for performing the day to day job duties. This experience is necessary to make foundational decisions. Experience in proficiently translating complex technical This position specifically requires expert level knowledge in issues into readily understood concepts for staff, the tools utilized to perform job duties. This experience is management, and the public. necessary in order to perform the essential functions of the job and day to day activities. Desirable/Preferred Education, Experience or Application (why each qualification exists) Certifications Bachelor’s degree in computer science or closely Educational experience is desired to ensure incumbent has related fields such as , foundational education in the IT field. Decisions made must Mathematics, Engineering or Informatics. have knowledge of how IT systems and components interact with each other. Experience working with Agile, or other iterative Experience is desired in working with different methodologies development methodology development methodologies. in software/system development lifecycles. Desired experience in this area supports the strategic direction of HTS in software configuration and development. Two (2) years SQL Management Studio tools or This position desires knowledge in the tools utilized to equivalent. perform job duties. This desired knowledge would benefit the position to perform data validation functions of the job and day to day activities. Two (2) years of Software Testing This position desires knowledge in the tools utilized to perform job duties. This desired knowledge would benefit the position to perform functions of the job and day to day activities. One (1) year of software training experience This position desires knowledge in the tools utilized to perform job duties. This desired knowledge would benefit the position to perform functions of the job and day to day activities. Professional Certifications in Business Analysis This position desires this type of profession level certification. This desired certification supports the functions of the position and day to day activities. Experience with Lean practices Lean is a standard tool for the agency and many of our practices incorporate lean methodology. This could be trained but it is a desired knowledge/skill for all employes List the competencies (knowledge, skills, abilities and behaviors) and a description of each that are necessary to successfully perform the work of the position. Core Competencies

Achievement Orientation • Adds value through personal contribution, technical knowledge, and group achievements. • Meets productivity standards, deadlines and work schedules. Self-directed with excellent follow through and attention to details. Must be able to multi-task.

OFM 12-082 (3/31/17) Information Technology Position Description Page 7 • Provides products and services that consistently meet or exceed the needs and expectation of customers. • Consistently produces accurate and timely work with general supervision. • Demonstrates ability to break down problems into simple lists of tasks or activities. Self-directed to achieve efficiencies in resource deployment. • Models effective team member behavior such as integrity, credibility, enthusiasm, commitment, honesty and caring.

Analysis and Problem Solving • Apply quality improvement tools to improve efficiency, accuracy, and overall quality. • Demonstrates ability to address problems with new and effective solutions. • Identifies issues, addresses problems, and adapts new information to strategies. • Identifies relevant and appropriate data and information sources. • Identifies and collaborates with appropriate parties in developing recommended options to resolve issues, problems, and complaints. • Effectively uses performance measures and data to identify opportunities and measure process improvement. • Recognizes the scope of problems and understands the impact of change on others. Ability to see the big picture; anticipate problems and develop contingency plans. • Uses negotiation skills to mediate disputes and resolve problems. • Ability to explore and document options, and to formulate policy recommendations. • Critical thinker with strong analytical skills. • Strong planning and organizational skills.

Communication • Demonstrates ability to effectively give and receive information both orally and in writing to diverse audiences. • Speaks and writes clearly and concisely avoiding bureaucratic language and jargon whenever possible - Ability to represent business perspective in a technical world. • Demonstrates understanding and empathy with the listener or reader. • Is timely in response to emails, phone messages, and mail. • Participates in meetings in an active, , and courteous manner. • Effectively uses the media, advanced technologies (especially the Internet), and community networks to communicate information. • Shares appropriate information internally and externally. • Is open to feedback from staff, peers, and supervisors.

Cultural Competency • Models and facilitates the development and integration of cultural, ethnic, and gender sensitivity and competence. • Demonstrates respect for others regardless of their position and educates self through study and analysis. • Actively seeks out different points of view and leverages the benefits of different perspectives. • Develops and adapts approaches to problems that take into account cultural differences. • Facilitates and encourages the development of a diverse public health workforce. • Integrates cultural, social, and behavioral factors in determining the delivery of public health services. • Uses appropriate methods to interact professionally, sensitively, and effectively with persons of all ages and lifestyle preferences, and from diverse cultural, racial, socioeconomic, educational, ethnic and professional backgrounds, of all ages and lifestyle preferences. • Ability to state and write clear and concise policy statements.

Customer Service Orientation • Consistently demonstrates to customers an interest in them and in solving their problems. • Uses the customers' perspectives on problems and how the outcome affects the organization to guide decision making and problem solving. • Develops and maintains effective working relationships with customers. • Takes the initiative to influence changes to products, processes, and regulations that do not meet customer needs. • Takes extra efforts to meet customer needs, expectations. • Takes the time to actively listen and to ensure an understanding of what the customer wants. • Consistently meets customers’ needs in a timely fashion.

Interpersonal Skills • Adapts to and works effectively with a variety of situations and people. • Consistently models trustworthiness, sensitivity to others and respect. • Provides timely and honest feedback in a constructive and non-threatening way. • Models effective group process behavior, such as listening, discussing, negotiating, rewarding, encouraging and motivating. OFM 12-082 (3/31/17) Information Technology Position Description Page 8 • Anticipates and seeks to resolve confrontations and disagreements in a constructive manner. • Demonstrates diplomacy, tact, and discretion when dealing with others. • Takes responsibility for failures and mistakes without blaming others or the circumstances. • Consistently demonstrates a positive attitude toward the organization, customers and work in general.

IT Business Analysis Functional Competencies • Professional knowledge of Business Analysis Planning and Monitoring • Professional knowledge of Business Analysis Elicitation and Collaboration • Professional knowledge of Business Analysis Requirements Life Cycle Management • Professional knowledge of Business Analysis Strategy Analysis • Professional knowledge of Business Analysis Requirements Analysis and Design Definition • Professional knowledge of Business Analysis Solution Evaluation.

IT Testing Functional Competencies

• Professional level knowledge of Test Management Planning • Professional level knowledge of Unit Testing • Professional level knowledge of Requirements Testing • Professional level knowledge of User Testing • Professional level knowledge of Load Testing • Professional level knowledge of Functional Testing • Professional level knowledge of Performance Testing • Professional level knowledge of Regression Testing • Professional level knowledge of Integration Testing

IT Application Development Functional Competencies • Professional knowledge of Software and Application Development lifecycle • Professional knowledge of application and configuration development • Professional knowledge of application design, interface and functional specifications.

IT Technical Consulting Functional Competencies • Professional level knowledge of providing long term strategic consultation • Professional level knowledge of providing change management consultation

Special Requests and Conditions of Employment Examples: Must possess valid drivers’ license and good driving record. Must successfully pass a criminal background check.

Working Conditions Work Setting, including hazards Work will be performed remotely at home or in the facilities of the Department of Health located in Tumwater. Work indoors at a desk the majority of an eight-hour workday, in an open air environment with possible conversation and noise distractions Manage potentially stressful situations and work load demands Willing to learn new software applications Willingness and commitment to use division and agency standard processes for documenting software requirements Able to function well with daily challenges and changes Able to interact with co-workers in person, via telephone, and via email Able to demonstrate success in working in a team environment and contributing to the team’s success Schedule (i.e., hours and days) Standard work week in one of the agency-approved schedules Willing to occasionally work in excess of 40 hours per week or on weekends to meet critical deadlines

OFM 12-082 (3/31/17) Information Technology Position Description Page 9 Travel Requirements Ability to occasionally travel within and outside of Washington State to meet business needs Have valid Washington State driver’s license and the ability to operate a state vehicle or the alternate ability to travel around the state. Able to travel alone, with another person, overnight, several days and /or out of state Tools and Equipment Remote access to core Agency applications to be provided via Citrix and VPN accordance with DOH Telecommuting policies. Able to use copiers and printers along with standard office furniture & equipment (such as computer and telephone) Customer Relations Able to effectively interact with the public, and business customers on the phone or on site External - Local Health Jurisdictions, tribes, medical facility staff and IT vendors. Internal – Division staff, HTS Staff, HR Staff, ORM staff, others as applicable depending on situation. Other Assists with emergency response activities as assigned during a public health emergency. Acknowledgement of Position Description The signatures below indicate that the job duties as defined above are an accurate reflection of the work performed by this position. Date Supervisor’s/Manager’s Signature (required) Enter text.

Date Appointing Authority’s Name and Title 4/9/2021 Callie Goldsby, Deputy Chief Information Officer

Signature (required)

/s/Callie Goldsby As the incumbent in this position, I have received a copy of this position description. Date Employee’s Signature Enter text.

OFM 12-082 (3/31/17) Information Technology Position Description Page 10 Position details and related action have been taken by Human Resources as reflected below. For Human Resource/Payroll Office Use Only Approved Class Title: Class Code: Salary Range: Effective Date: IT Business Analyst - 483BA 05IT 4/1/2021 Journey Pay Scale Type: Job Analysis On File? Position Type (Employee EEO Category: ☐ ☒ Enter text. Yes No Group): Project comp Enter text. Employee Sub-Group: Position Retirement Eligible: Position is: Workers Comp. Code: Enter text. Yes ☒ No ☐ Funded ☒ Non-Funded ☐ 4902 County Code: Business Area: Personnel Area (FEIN): Tumwater Enter text. Enter text. Position Eligible for Telework Position Eligible for Flextime Yes ☒ No ☐ Yes ☒ No ☐ Position Eligible for Compressed Workweek Unique Facility Identifier (UFI) Yes ☒ No ☐ For more information see: UFI Search Feature Enter text. Bona Fide Occupational Qualification Yes ☐ No ☐ If yes, list qualifications: Enter text. Cost Center Codes COST PCT. (%) FUND FUNCTIONAL COST OBJECT AFRS PROJECT AFRS ALLOCATION CENTER AREA Enter text. Enter text. Enter text. Enter text. Enter text. Enter text. Enter text.

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Enter text. Enter text. Enter text. Enter text. Enter text. Enter text. Enter text. Date: HR Designee’s Name: HR Designee’s Title: HR Designee’s Signature: 4/19/2021 Annie Manning HR Consultant /s/ Annie Manning Date: Budget Designee’s Name: Budget Designee’s Title: Budget Designee’s Enter a date. Enter text. Enter text. Signature: Enter text.

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