State of Arizona
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.
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 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 (Central Quality Management 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.
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).
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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 Quality Management System 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.
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