TravelNurseSource is working with Cynet Health to find a qualified Med/Surg RN in Phoenix, Arizona, 85012!
Job Title: Quality of Care Investigative Nurse
Profession: RN
Specialty: Staff Augmentation
Duration: 22 weeks
Shift: Day
Hours per Shift: 8:00 AM - 5:00 PM
Experience: Minimum years of experience required
License: Active license to practice as a Registered Nurse (RN) in the state of Arizona
Certifications: Required certifications as per state regulations
Must-Have:
- Critical thinking skills
- Technological skills, including the use of databases and Microsoft Office products
- Proficiency in producing professional technical reports and letters
- Strong research and analysis abilities
- Excellent oral and written communication skills
- Personal planning, organization, and time management skills
- Experience in medical chart review
- Knowledge of the nursing process, including assessment, monitoring, and evaluation
- Strong decision-making skills
Description:
This position reports to the Quality Management Unit and conducts quality-of-care investigations.
The role involves investigating member-centric and systemic quality-of-care concerns.
Timely and thorough investigations are essential to ensure member health and well-being.
The candidate will implement vendor-specific corrective action plans using a standardized process.
Appropriate referrals to oversight and regulatory agencies will be made as necessary.
Participation in Care Concerns and member issues as assigned is required.
All necessary documentation to support casework must be maintained.
The candidate will request appropriate documentation for quality-of-care investigations.
Comprehensive case records will be maintained to support allegation review and substantiation levels.
Based on the investigations, issue remediation or a Corrective Action Plan will be issued to vendors.
All investigative information and documents must be appropriately uploaded into the relevant systems.
Elevating cases and/or trend concerns to the supervisor will be necessary.