Quality Assurance Investigative Nurse

Would you like to be part of an amazing team that makes Arizona stronger by helping Arizonans reach their full potential through temporary assistance for those in need, and care for the vulnerable? The Arizona Department of Economic Security (DES) is looking for individuals that 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 Quality Assurance 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.

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 Arizona Health Care Cost Containment System (AHCCCS) Quality Management System (QMS) Portal; appropriately elevates cases and/or trend concerns to QOC supervisor
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

Knowledge in:
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
Technological skills including use of data bases, Microsoft Office products, email and electronic referral and verification sources
Skills in:
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 to effectively relate to AHCCCS members, their families, and Agency stakeholders
Critically analyzing problems and developing 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
Work independently and with a variety of internal and external customers
Accommodate changing requirements or standards

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

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. Any employee operating a motor vehicle on State business must possess and retain a current, valid class-appropriate driver's license, complete all required training, and successfully pass all necessary driver's license record checks. The license must be current, unexpired, and neither revoked nor suspended. Employees who drive on state business are subject to driver's license record checks, must maintain acceptable driving records, and must complete all required driver training. An employee who operates a personally owned vehicle on state business shall maintain the statutorily required liability insurance (see Arizona Administrative Code (A.A.C.) R2-10-207.11). Successfully pass background and reference checks; employment is contingent upon completion of the above-mentioned process and the agency's ability to reasonably accommodate any restrictions.
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.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Required at 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
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
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.
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
Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees

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
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

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.

For questions about this career opportunity, please contact us Humaira Patwary at 480-272-5809 or hpatwary@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 480-272-5809 or hpatwary@azdes.gov. Requests should be made as early as possible to allow time to arrange the accommodation.