Quality Of Care Concern Nurse

Arizona Department of Administration•Phoenix, AZ

1d•Onsite

About The Position

The Arizona Department of Economic Security’s Division of Developmental Disabilities (DDD) is seeking an experienced and motivated nurse to investigate member quality-of-care concerns and support high-quality, member-driven services for people with developmental disabilities and their families. The position is based at 4000 North Central Avenue in Phoenix, Arizona. Salary is $66,000–$78,000, Grade 22. Applicants cannot 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. The role conducts member-centric and systemic investigations, documents findings, tracks trends, and works with vendors and oversight agencies to address concerns and ensure compliance with AHCCCS policies, contractual requirements, and applicable standards. The nurse also participates in care concern matters, peer review, technical assistance, and focused audits or reviews. A current Arizona registered nurse license is required at appointment. Employment is contingent on background and reference checks and completion of E-Verify. The employee must hold a valid Arizona Level One fingerprint clearance card and pass searches of the Department of Child Safety and Adult Protective Services registries. Employees who operate a motor vehicle on state business must maintain a valid, appropriate driver's license and meet related training, record-check, and insurance requirements.

Requirements

Possess a current license to practice as a registered nurse in Arizona at the time of appointment.
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 health care 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.
Ability to produce professional technical reports and letters; conduct research and analysis; and communicate orally and in writing.
Personal planning, organization, and time-management skills.
Medical chart review skills and knowledge of the nursing process, including assessment, monitoring, and evaluation.
Decision-making skills and strong interpersonal skills to relate effectively to AHCCCS members, their 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 varied sources; work independently with internal and external customers; and accommodate changing requirements or standards.
Successfully pass background and reference checks; employment is contingent on completing the process and the Agency's ability to reasonably accommodate any restrictions.
Obtain and maintain a valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-1968.
Pass searches of the Department of Child Safety Central Registry and the 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 license-record checks. Maintain an acceptable driving record and statutorily required liability insurance when using a personally owned vehicle for state business.
Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), as required of newly hired State employees.

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 the standardized process.
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 trend concerns to the QOC supervisor as appropriate.
Maintain documentation supporting casework, request appropriate records for investigations, and ensure comprehensive case records support allegation review and substantiation levels.
Participate in peer review meetings, provide technical assistance, and take part in focused audits and reviews to ensure compliance with contractual and policy requirements.
Ensure work aligns with AHCCCS policies.

Benefits

Affordable medical, dental, life, and short-term disability insurance plans.
Participation in the Arizona State Retirement System 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.