QA INVESTIGATE NURSE (Central QM Investigative Nurse)

DEPARTMENT OF ECONOMIC SECURITY

Your Partner For A Stronger Arizona.

DES works with families, community organizations, advocates and state and federal partners to realize our collective vision: A thriving Arizona.

DES serves more than 3 million Arizonans. Our Mission is to strengthen individuals, families, and communities for a better quality of life.

QA INVESTIGATE NURSE

(Central QM Investigative Nurse)

Job Location:

Address:  Division of Developmental Disabilities (DDD)
4000 N. CENTRAL AVENUE, SUITE 400, PHOENIX, AZ 85007

Posting Details:

Salary: $66,000.00 to $78,000.00  

Grade: 22

Closing Date: 11/02/2024

Job Summary:

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 or click on the link here 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 QA Investigate Nurse (Central QM Investigative 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 reports within the Division of Developmental Disabilities-Quality Management Unit and is responsible for quality-of-care investigations and resolutions pursuant to a contract between the Division and the Arizona Health Care Cost Containment System (AHCCCS) to implement and operate the provisions of the Arizona Long Term Care System. This position is responsible for monitoring and evaluating the quality of services provided to members to ensure the health and safety of those who receive services within the statewide program.

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.

Job Duties:

Essential duties and responsibilities include but are not limited to:
• 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.

Knowledge, Skills & Abilities (KSAs):

Knowledge Of:
• 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 disables and /or those receiving long term services
• Quality Management and Utilization Management Processes.
Skills In:
• 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.
Ability To:
• 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 and with a variety of internal and external customers.
• Accommodates changing requirements or standards.

Selective Preference(s):

The ideal candidate for this position will have:
One (1) year of experience working with Intellectual Disability population.

Pre-Employment Requirements:

•Required at the 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 41-2758.07 in order to work with children and vulnerable adults.
•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.
•Candidates for this position shall be subject to a search of the Child Protective Services Central Registry pursuant to A.R.S. 8-804.
•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.
•All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Benefits:

The Arizona Department of Economic Security offers a comprehensive benefits package to include:

• 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
• Vacation time accrued at 4.00 hours bi-weekly for the first 3 years
• Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
• Sick time accrued at 3.70 hours bi-weekly
• Deferred compensation plan
• Wellness plans
• Tuition Reimbursement
• Stipend Opportunities
• Infant at Work Program
• Rideshare and Public Transit Subsidy
• Career Advancement & Employee Development Opportunities
• Flexible schedules to create a work/life balance

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Retirement:

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.

Contact Us:

For questions about this career opportunity, please contact us Alyssa Figueroa at 602-653-9837 or alyssafigueroa@azdes.gov.

The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-653-9837 or alyssafigueroa@azdes.gov. Requests should be made as early as possible to allow time to arrange the accommodation.

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