RN - Quality of Care Investigative Nurse. - Phoenix, AZ - RP 26-13003

Job Title: Registered Nurse – Quality of Care Investigative Nurse
Location: Phoenix, AZ
Job Type: Contract
Duration: 39 Weeks
Shift & Schedule: Day Shift | 8:00 AM – 5:00 PM | Monday – Friday | 40 Hours/Week
Local Candidates Required: Yes
Traveler Candidates Required: No

Pay Rate: $33 – $35/hr

Note: This job doesn't offer any benefits.

Position Overview
We are seeking a Registered Nurse to conduct quality-of-care investigations, review medical records, analyze findings, and support corrective action activities.

Required Qualifications

• Active Registered Nurse (RN) license.

• Experience with medical chart review.

• Strong nursing assessment, monitoring, and evaluation skills.

• Strong critical-thinking, decision-making, research, and analytical skills.

• Strong written and verbal communication skills.

• Experience with databases, Microsoft Office, email, and electronic systems.

• Ability to prepare professional technical reports and correspondence.

• Strong organization, planning, and time-management skills.

• Ability to analyze problems and develop corrective action plans.

Responsibilities

• Conduct timely and thorough quality-of-care investigations.

• Investigate member quality-of-care concerns and systemic quality issues.

• Request and review medical records and supporting documentation.

• Maintain comprehensive case records to support allegation review and substantiation.

• Make appropriate referrals to oversight and regulatory agencies.

• Participate in assigned member care concerns and quality issues.

• Develop or issue vendor-specific corrective action plans when appropriate.

• Upload investigative information and documentation to the required quality management system.

• Monitor remediation and corrective action activities.

• Identify and escalate cases and trends to the QOC Supervisor.

• Apply the nursing process, including assessment, monitoring, and evaluation.

• Research, analyze, and document findings related to quality-of-care concerns.