Job Details

Why consider this job opportunity

• Salary up to $72,132
• Opportunity for career advancement and growth within the organization
• Flexible remote work options available within Arizona
• Comprehensive benefits package including paid holidays, vacation, and a robust retirement program
• Supportive and collaborative work environment with high employee engagement
• Chance to make a positive impact on the quality of care for members

What to Expect (Job Responsibilities)

• Monitor compliance with State and Federal regulations regarding quality management processes and resolve quality of care issues
• Conduct comprehensive assessments of service providers and individual members to ensure compliance with regulations
• Perform on-site investigations related to health and safety concerns, including urgent situations outside normal hours
• Develop improved processes and procedures to enhance unit efficiency and lead special projects
• Provide education and technical assistance to stakeholders regarding services and compliance requirements

What is Required (Qualifications)

• Current license to practice as a registered nurse in the State of Arizona
• Minimum of three (3) years of relevant healthcare experience
• Knowledge of State and Federal Policies governing healthcare services and regulations
• Strong communication skills, both verbal and written
• Ability to make independent decisions and assess health-related variables

How to Stand Out (Preferred Qualifications)

• At least one year of experience working in a managed care environment
• Experience in Case Management, Quality Management, or Utilization Management
• Certification as a Professional in Healthcare Quality or in case management

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