Remote RN - Quality of Care

A-Line Staffing is now hiring a Quality-of-Care Investigative Nurse – RN

• Schedule: Monday–Friday, 8:00 AM–5:00 PM
• Pay Rate - $37.28 an hour paid weekly
• Benefits – active after 90 days
• Work Arrangement: The first day will be conducted in person in Phoenix to receive necessary equipment and complete required security training for system access. Remaining training will be completed remotely.

Key Responsibilities

• Conduct thorough, timely, member-centered, and systemic investigations of quality-of-care concerns.
• Review medical records, clinical documentation, and other relevant information as part of the investigative process.
• Request appropriate documentation and maintain comprehensive case records supporting allegation review and substantiation.
• Research, analyze, and evaluate information to determine appropriate investigative findings.
• Develop and implement vendor-specific corrective action plans when indicated.
• Issue appropriate remediation or Corrective Action Plans based on investigation findings.
• Make appropriate referrals to oversight and regulatory agencies when necessary.
• Participate in Care Concerns, Care Needed Today, and other member issues as assigned.
• Ensure all required investigative information and documentation is accurately uploaded into the AHCCCS QMS Portal.
• Maintain accurate and complete documentation throughout the investigation process.
• Identify and appropriately elevate individual cases, trends, and systemic concerns to the Quality of Care supervisor.
• Prepare professional technical reports, letters, and other written documentation.
• Apply nursing knowledge and clinical judgment to assess quality-of-care concerns and support appropriate corrective actions.

Required Qualifications

• Active Registered Nurse (RN) license in the State of Arizona
• 6 months to a year of risk management, quality assurance nurse or auditing experience

INDKS