QUALITY ASSURANCE INVESTIGATIVE NURSE

Arizona Department of Administration•Phoenix, AZ

4d•$66,000 - $78,000

About The Position

Would you like to be part of an amazing team that makes Arizonans thrive? At the Arizona Department of Economic Security (DES) we strengthen individuals, families, and communities for a better quality of life. DES is looking for individuals who are committed to service, community, and teamwork. To learn more about DES please visit des.az.gov [https://des.az.gov/] or click here [https://youtu.be/Nik5MiXqOV8] on the link to view ‘Our DES’ video. Come Join the DES Team! The Department of Economic Security, Division of Developmental Disabilities (DDD), is seeking an experienced and highly motivated individual to join our team as a Quality Assurance Investigate Nurse. DDD provides individuals with developmental disabilities, and their families, services and supports that are flexible, high quality, and member driven. These services provide individuals with opportunities to exercise their rights and responsibilities of independent decision-making and engagement in the community.

Requirements

Applicable Laws, rules, policies, procedures and standards related to acute care delivery
Nursing scope of practice and quality management.
AHCCCS, DHS and CMS rules and regulations.
Project management principles, professional report and technical writing principles.
General Laws and reporting regulations for abuse and neglect of vulnerable populations.
Health Care Issues and standards of care for vulnerable populations including developmentally disabled and /or those receiving long term services.
Quality Management and Utilization Management Processes.
Technological skills including use of data bases, Microsoft Office products, email and electronic referral and verification sources.
Producing professional technical reports and letters.
Research and analysis. Oral and written communication skills.
Personal planning, organization and time management.
Medical chart review.
Nursing Process including assessment, monitoring, and evaluation.
Decision making skills.
Strong interpersonal skills in order to effectively relate to AHCCCS members, their families, and Agency stakeholders.
Critically Analyze problems and develop effective plans for corrective action.
Interpret rules, laws, and policies and apply to unique case circumstances.
Work in a fast paced environment.
Organize, prioritize and track files and information from various sources.
Works independently and with a variety of internal and external customers.
Accommodates changing requirements or standards.
Successfully pass background and reference check; employment is contingent upon completion of the above-mentioned process and the Agency's ability to reasonably accommodate any restrictions.
All newly hired State employees are subject to and must successfully complete the •Electronic Employment Eligibility Verification Program (E-Verify).
Required at time of appointment: possession of a current license to practice as a registered nurse in the State of Arizona.
Employee shall have a valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-1968 in order to work with children and vulnerable adults.
Candidates for this position shall be subject to a search of the Child Protective Services Central Registry pursuant to A.R.S. 8-804.
In-state travel is required. This position requires possession of and ability to retain a current, valid state-issued driver’s license appropriate to the assignment. Employees who drive on state business are subject to driver’s license record checks, must maintain acceptable driving records and must complete any required driver training (see Arizona Administrative Code R2-10-207.12.). 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.

Nice To Haves

One (1) year of experience working with the Intellectual Disability population.

Responsibilities

Conducts timely, thorough member-centric and systemic investigations for all division member quality of care issues and places vendor specific corrective action plans in place utilizing standardized process. Makes appropriate referrals to oversight and regulatory agencies.
Participates in Care Concerns, Care Needed today member issues as assigned.
Conducts tracking and trending of member-centric and systemic Quality of Care (QOC) issues and vendor specific Corrective Action Plan resolution Results in Division databases and in the AHCCCS QMS Portal. Appropriately elevates cases and/or trend concerns to QOC supervisor.
Maintains all necessary documentation to support case work. Request appropriate documentation for quality of care investigations and ensures maintenance of comprehensive case records to support allegation review and substantiation levels.
Participates in Peer Review Meetings, technical assistance, focused audits/ reviews to ensure compliance with contractual and policy requirements. Ensures all work is in alignment to AHCCCS policies.

Benefits

Affordable medical, dental, life, and short-term disability insurance plans
Participation in the Arizona State Retirement System (ASRS) and long-term disability plans
10 paid holidays per year
Paid vacation and sick time
Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child.
Deferred compensation plan
Wellness plans
Tuition Reimbursement
Stipend Opportunities
Infant at Work Program
Rideshare and Public Transit Subsidy
Career Advancement & Employee Development Opportunities.