QUALITY OF CARE CONCERN NURSE

Arizona Department of Administration•Phoenix, AZ

3d•$66,000 - $78,000

About The Position

The Arizona Department of Economic Security (DES), Division of Developmental Disabilities (DDD), is seeking an experienced and highly motivated Quality of Care Concern Nurse. DDD provides individuals with developmental disabilities and their families flexible, high-quality, member-driven services and supports that promote independent decision-making and community engagement. The nurse investigates member quality-of-care concerns, tracks and analyzes cases and trends, documents findings, and supports corrective action and compliance with contractual, policy, and regulatory requirements. The position works with members, families, agency stakeholders, vendors, and oversight agencies. Applicants may not be licensed or certified by the DDD Office of Licensing Certification and Regulation; have a principal interest in, or a spouse or close family member with a principal interest in, a DDD Qualified Vendor Agreement; or be employed or subcontracted by a DDD Qualified Vendor. Appointment requires a current Arizona registered nurse license, background and reference checks, and a valid Level One fingerprint clearance card. Other pre-employment checks and conditions are described in the posting.

Requirements

Current license to practice as a registered nurse in the State of Arizona at the time of appointment.
Successfully pass background and reference checks; employment is contingent on completion of the process and the Agency's ability to reasonably accommodate any restrictions.
Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), as required for newly hired State employees.
Have a valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-1968 to work with children and vulnerable adults.
Be subject to searches of the Department of Child Safety Central Registry and Adult Protective Services Registry.
If operating a motor vehicle on State business, possess and retain a current, valid class-appropriate driver's license, complete required training, and pass required driving record checks; maintain acceptable driving records and legally required liability insurance when using a personally owned vehicle on State business.
Knowledge of applicable laws, rules, policies, procedures, and standards related to acute care delivery, nursing scope of practice, and quality management.
Knowledge of AHCCCS, DHS, and CMS rules and regulations.
Knowledge of project management principles and professional report and technical writing principles.
Knowledge of laws and reporting regulations concerning abuse and neglect of vulnerable populations.
Knowledge of healthcare issues and standards of care for vulnerable populations, including people with developmental disabilities and/or people receiving long-term services.
Knowledge of Quality Management and Utilization Management processes.
Technological skills, including use of databases, Microsoft Office products, Google Suite, email, and electronic referral and verification sources.
Skill in producing professional technical reports and letters; research and analysis; and oral and written communication.
Personal planning, organization, and time-management skills.
Medical chart review skills.
Knowledge and application of the nursing process, including assessment, monitoring, and evaluation.
Decision-making skills and strong interpersonal skills for effectively relating to AHCCCS members, families, and agency stakeholders.
Ability to critically analyze problems and develop effective corrective action plans.
Ability to interpret rules, laws, and policies and apply them to unique case circumstances.
Ability to work in a fast-paced environment; organize, prioritize, and track files and information from various sources; work independently and with internal and external customers; and accommodate changing requirements or standards.

Nice To Haves

One year of experience working with the Intellectual Disability population.

Responsibilities

Conduct timely, thorough, member-centric and systemic investigations of division member quality-of-care issues and establish vendor-specific corrective action plans using standardized processes; make appropriate referrals to oversight and regulatory agencies.
Participate in assigned Care Concerns and Care Needed Today member issues.
Track and trend member-centric and systemic quality-of-care issues and vendor-specific corrective action plan resolutions in division databases and the AHCCCS QMS Portal; elevate cases or trends to the quality-of-care supervisor as appropriate.
Maintain documentation and comprehensive case records, request appropriate investigation documentation, and support allegation review and substantiation levels.
Participate in peer review meetings, technical assistance, and focused audits or reviews to ensure compliance with contractual and policy requirements and alignment with 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 of up to 12 weeks per year for a newborn or newly placed foster or adopted child.
Deferred compensation plan.
Wellness plans.
Tuition reimbursement.
Stipend opportunities.
Infant at Work Program.
Rideshare and public transit subsidy.
Career advancement and employee development opportunities.