Quality Assurance Investigative Nurse

Would you like to be part of an amazing culture that helps Arizonans reach their full potential through providing services to support them? The Arizona Department of Economic Security (DES) is looking for individuals that are committed to service, community, and teamwork.
The Department of Economic Security, Division of Developmental Disabilities (DDD), is seeking an experienced and highly motivated individual to join our team as a Central Investigative Management 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. This position is responsible for:

• 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 Arizona Health Care Cost Containment System (AHCCCS) Quality Management System (QMS) Portal; appropriately elevates cases and/or trend concerns to QOC supervisor
• 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
• Maintains all necessary documentation to support case work; requests 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

• Ability to accommodate changing requirements or standards
• Skills in Nursing Process including assessment, monitoring, and evaluation
• Knowledge of applicable laws, rules, policies, procedures and standards related to acute care delivery, Nursing scope of practice and quality management
• Knowledge of general Laws and reporting regulations for abuse and neglect of vulnerable populations
• Decision making skills
• Ability to work in a fast-paced environment
• Skills in medical chart review
• Skills in producing professional technical reports and letters
• Knowledge of Quality Management and Utilization Management Processes
• Strong interpersonal skills to effectively relate to AHCCCS members, their families, and Agency stakeholders
• Ability to interpret rules, laws, and policies and apply to unique case circumstances
• Knowledge of project management principles
• Skills in oral and written communication skills
• Technological skills including use of data bases, Microsoft Office products, email and electronic referral and verification sources
• Knowledge of AHCCCS, DHS and CMS rules and regulations
• Knowledge of Health Care Issues and standards of care for vulnerable populations including developmentally disables and /or those receiving long term services
• Skills in critically analyzing problems and developing effective plans for corrective action
• Ability to organize, prioritize and track files and information from various sources
• Ability to work independently and with a variety of internal and external customers
• Skills in personal planning, organization, and time management
• Knowledge of professional report and technical writing principles
• Skills in research and analysis

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

• Employee shall have a valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-2758.07 in order to work with children and vulnerable adults
• Required at time of appointment: Possession of a current license to practice as a Registered Nurse in the State of Arizona
• Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees
• 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
• 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.
• Candidates for this position shall be subject to a search of both the Child Protective Services Central Registry pursuant to A.R.S. 8-804 and the Adult Protective Services Registry pursuant to A.R.S. 46-459

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

State employees are required to participate in the Arizona State Retirement System (ASRS), the State sponsored retirement contribution plan and the Long-Term Disability (LTD) program after a 27-week waiting period. The ASRS defined benefit plan provides for life-long income upon retirement. You will also have the option to participate in a voluntary deferred compensation program to take advantage of tax-deferred retirement investments.
On, or shortly after, your first day of work you will be provided with additional information about the available insurance plans, enrollment instructions, submission deadlines and effective dates.

Apply through azstatejobs.azdoa.gov. For questions about this career opportunity, please call Humaira Patwary (480) 272-5809 or email [email protected].
Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting (480)-272-5809. Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.