Arizona Department of Economic Security
QUALITY ASSURANCE INVESTIGATIVE NURSE
Arizona Department of Economic Security, Phoenix, Arizona, United States, 85003
Overview
QUALITY ASSURANCE INVESTIGATIVE NURSE role at Arizona Department of Economic Security (DES). DES works with families, community organizations, advocates and state and federal partners to realize a thriving Arizona and strengthen individuals, families, and communities for a better quality of life. Job location: Division of Developmental Disabilities (DDD), 4000 N. Central Avenue, Phoenix, AZ 85007. Grade: 22. Salary: $66,000.00 - $78,000.00. Closing Date: 10/29/2025. Job Summary
DES is seeking an experienced and highly motivated individual to join the team as a Quality Assurance Investigative Nurse. DDD provides services and supports for individuals with developmental disabilities and their families, focused on flexible, high-quality, member-driven care. Job Duties
Conduct timely, thorough member-centric and systemic investigations for all division quality of care issues and implement vendor-specific Corrective Action Plans using standardized processes. Make referrals to oversight and regulatory agencies. Participate in Care Concerns, Care Needed Today member issues as assigned. Track and trend member-centric and systemic Quality of Care (QOC) issues and vendor-specific CAP resolution results in Division databases and the AHCCCS QMS Portal. Elevate cases/trends to QOC supervisor as needed. Maintain documentation to support case work; request necessary documentation for quality of care investigations and ensure comprehensive case records to support review and substantiation. Participate in Peer Review Meetings, technical assistance, and focused audits/reviews to ensure compliance with contractual and policy requirements; ensure alignment with AHCCCS policies. Knowledge, Skills & Abilities (KSAs)
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. General laws and reporting regulations for abuse and neglect of vulnerable populations; health care issues and standards of care for vulnerable populations including individuals with developmental disabilities and/or those receiving long-term services; quality management and utilization management. Skills
Technological skills including use of databases, Microsoft Office, email and electronic referral and verification sources. Producing professional technical reports and correspondence. Research and analysis; oral and written communication; personal planning, organization and time management. Medical chart review; nursing process including assessment, monitoring, and evaluation; decision making; strong interpersonal skills to relate to AHCCCS members, families, and Agency stakeholders. Critical thinking to analyze problems and develop corrective action plans. 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. Selective Preference
The ideal candidate will have one (1) year of experience working with the Intellectual Disability population. Pre-Employment Requirements
Possession of a current license to practice as a registered nurse in the State of Arizona at time of appointment. Valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-1968 to work with children and vulnerable adults. Subject to background checks including Department of Child Safety Central Registry and Adult Protective Services Registry. Successful pass of background and reference checks; employment contingent on completion of processes and reasonable accommodation availability. All newly hired State employees must complete the Electronic Employment Eligibility Verification Program (E-Verify). If driving is an essential function, meet Driver's License requirements. Benefits and Retirement
The DES offers a comprehensive benefits package including: Medical, dental, life, and short-term disability insurance ASRS retirement and long-term disability plans 10 paid holidays per year Vacation and sick time accrual Parental leave options Deferred compensation, wellness, tuition reimbursement, and other benefits For a complete list of benefits, visit the State of Arizona benefits page. Contact
For questions about this opportunity, contact Alyssa Figueroa at 602-653-9837 or alyssafigueroa@azdes.gov. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer. Persons with a disability may request accommodations by contacting the same number or email. Requests should be made as early as possible to arrange accommodations. Additional Information
Seniority level: Mid-Senior level Employment type: Other Job function: Health Care Provider Industries: Government Administration
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QUALITY ASSURANCE INVESTIGATIVE NURSE role at Arizona Department of Economic Security (DES). DES works with families, community organizations, advocates and state and federal partners to realize a thriving Arizona and strengthen individuals, families, and communities for a better quality of life. Job location: Division of Developmental Disabilities (DDD), 4000 N. Central Avenue, Phoenix, AZ 85007. Grade: 22. Salary: $66,000.00 - $78,000.00. Closing Date: 10/29/2025. Job Summary
DES is seeking an experienced and highly motivated individual to join the team as a Quality Assurance Investigative Nurse. DDD provides services and supports for individuals with developmental disabilities and their families, focused on flexible, high-quality, member-driven care. Job Duties
Conduct timely, thorough member-centric and systemic investigations for all division quality of care issues and implement vendor-specific Corrective Action Plans using standardized processes. Make referrals to oversight and regulatory agencies. Participate in Care Concerns, Care Needed Today member issues as assigned. Track and trend member-centric and systemic Quality of Care (QOC) issues and vendor-specific CAP resolution results in Division databases and the AHCCCS QMS Portal. Elevate cases/trends to QOC supervisor as needed. Maintain documentation to support case work; request necessary documentation for quality of care investigations and ensure comprehensive case records to support review and substantiation. Participate in Peer Review Meetings, technical assistance, and focused audits/reviews to ensure compliance with contractual and policy requirements; ensure alignment with AHCCCS policies. Knowledge, Skills & Abilities (KSAs)
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. General laws and reporting regulations for abuse and neglect of vulnerable populations; health care issues and standards of care for vulnerable populations including individuals with developmental disabilities and/or those receiving long-term services; quality management and utilization management. Skills
Technological skills including use of databases, Microsoft Office, email and electronic referral and verification sources. Producing professional technical reports and correspondence. Research and analysis; oral and written communication; personal planning, organization and time management. Medical chart review; nursing process including assessment, monitoring, and evaluation; decision making; strong interpersonal skills to relate to AHCCCS members, families, and Agency stakeholders. Critical thinking to analyze problems and develop corrective action plans. 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. Selective Preference
The ideal candidate will have one (1) year of experience working with the Intellectual Disability population. Pre-Employment Requirements
Possession of a current license to practice as a registered nurse in the State of Arizona at time of appointment. Valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-1968 to work with children and vulnerable adults. Subject to background checks including Department of Child Safety Central Registry and Adult Protective Services Registry. Successful pass of background and reference checks; employment contingent on completion of processes and reasonable accommodation availability. All newly hired State employees must complete the Electronic Employment Eligibility Verification Program (E-Verify). If driving is an essential function, meet Driver's License requirements. Benefits and Retirement
The DES offers a comprehensive benefits package including: Medical, dental, life, and short-term disability insurance ASRS retirement and long-term disability plans 10 paid holidays per year Vacation and sick time accrual Parental leave options Deferred compensation, wellness, tuition reimbursement, and other benefits For a complete list of benefits, visit the State of Arizona benefits page. Contact
For questions about this opportunity, contact Alyssa Figueroa at 602-653-9837 or alyssafigueroa@azdes.gov. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer. Persons with a disability may request accommodations by contacting the same number or email. Requests should be made as early as possible to arrange accommodations. Additional Information
Seniority level: Mid-Senior level Employment type: Other Job function: Health Care Provider Industries: Government Administration
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