Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Teamwork
Quality Management Nurse
FIRST REVIEW 04/28/2019
This position will remain open until filled
Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Agency, is driven by the passion to deliver comprehensive and cost effective health care to Arizonans in need. AHCCCS is nationally acclaimed as a model for other Medicaid programs and recipient of multiple awards for excellence in workplace effectiveness and flexibility.
All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress. Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results. State employees are highly engaged, collaborative and embrace a culture of public service. Visit our careers page to learn more about AHCCCS. Use your skills to benefit others; join the AHCCCS Team!
The Division of Fee for Service Management (DFSM) is looking for a highly motivated individual to join our team as a Quality Management Nurse. This position is responsible for participating in the development, implementation, and monitoring of the DFSM quality care management functions, and works closely with the DHCM Clinical Quality Management Unit, other divisions with AHCCCS, and other state agencies. Major duties and responsibilities include but are not limited to:
* Participates in the development and implementation of the DFSM quality care management processes, policies, and procedures, as directed by the DFSM Quality Management Manager (HPM III).
* Performs research and data analysis, including tracking and trending of health and safety/immediate jeopardy situations involving FFS members.
* Develops and maintains reporting processes and metrics including LEAN principles and activities.
* Coordinates data, participates in on site reviews, and coordinates member movement as necessary in the event of serious incidents, health and safety, and immediate jeopardy situations involving FFS members, coordination with DHCM CQM, OIG, OALS, and other state agencies including ADHS Licensure, APS, DCS as applicable.
* Participates in the monitoring and oversight processes of FFS providers, including research and data analysis, investigation, provides technical assistance, and tracking and trending of quality of care concerns and health and safety/immediate jeopardy situations involving FFS providers.
KNOWLEDGE, SKILLS AND ABILITIES (KSAs):
* Holds a License as a Registered Nurse
* Knowledge of American Indian Tribes/ FFS Programs, Policies, and Intergovernmental Agreements.
* Strong interpersonal skills in working with agency management, and people of diverse cultures and socioeconomic backgrounds; project management to meet goals and deadlines.
* Strong ability to collaborate with others for mutually beneficial outcome to make effective decisions in a high volume fast faced environment; and strong organizational skills for setting priorities, workload and record keeping.
* Knowledge of current standards of medical/behavioral practice and modes of delivery for acute and non-acute medical/behavioral care/services.
* Skilled in nursing and clinical processes including assessment, planning, intervention, and evaluation.
* Ability to read, interpret and apply complex rules and regulations.
* Certified Professional in Healthcare Quality. At least one year professional healthcare industry experience in Quality or Utilization Management.
At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan. Click here to learn more about benefits.
Arizona State Government is an EOE/ADA Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 417-4497. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. AHCCCS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.
Click the APPLY NOW button to submit your application.
For technical assistance, email HRIShelpdesk@azdoa.gov or call 602-542-4700.