Health Plan Registered Nurse Quality of Care - Remote

Overview

The Health Plan Registered Nurse Quality of Care position involves coordinating the investigation of quality of care concerns for health plan members, utilizing nursing and quality management expertise.

In Short

• Investigate quality of care concerns and prepare cases for review.
• Coordinate with a cross-functional team to ensure patient care needs are met.
• Utilize triaging skills for referrals and case reviews.
• Work primarily in a remote hybrid setting with some facility visits.
• Requires Tucson, Arizona residency.
• Monday-Friday work schedule during Arizona business hours.
• Must possess a current RN license.
• Excellent communication and analytical skills required.
• Experience in quality management preferred.
• Competitive salary based on experience and education.

Requirements

• Two years of clinical experience in acute care or outpatient settings.
• One year of experience in a quality management role.
• Strong healthcare knowledge and understanding of Medicare regulations.
• Excellent written and verbal communication skills.
• Strong analytical and problem-solving skills.
• Ability to work independently and collaboratively.
• Knowledge of data management and quality improvement processes.
• Preferred: CPHQ certification.
• Preferred: Additional related education or experience.

Benefits

• Comprehensive benefits package for eligible positions.
• Career and lifestyle choices, including remote work options.
• Opportunities for professional growth and development.
• Supportive and collaborative work environment.
• Access to the latest technology in healthcare.