Health Plan Registered Nurse - Quality of Care - Remote

Overview

The Health Plan Registered Nurse in Quality of Care will coordinate the investigation of quality care concerns for members of the Banner University Health Plan, utilizing nursing expertise and quality management experience to ensure optimal patient care.

In Short

• Investigate quality of care concerns through medical record reviews.
• Prepare and present cases to the Medical Director.
• Assist in developing quality training programs.
• Communicate evaluation results to various stakeholders.
• Identify compliance issues during quality reviews.
• Work independently to manage quality indicators.
• Coordinate care to meet member needs while maintaining quality standards.
• Requires residency in Phoenix, Arizona.
• Remote hybrid work schedule.
• Monday to Friday work hours.

Requirements

• Two years of clinical experience in acute or outpatient settings.
• One year of quality management experience.
• Current RN license in state of practice.
• Knowledge of Medicare and state regulations.
• Strong written and verbal communication skills.
• Excellent analytical and problem-solving abilities.
• Ability to work independently and establish relationships.
• Experience with data management and reporting.
• CPHQ certification preferred.
• Additional education or experience preferred.

Benefits

• Comprehensive benefits package for eligible positions.
• Options for remote and hybrid work.
• Opportunities for career advancement.
• Supportive work environment focused on innovation.
• Work with a leading healthcare organization.