Quality of Care Investigative Nurse (RN)

Job Title: Quality of Care Investigative Nurse (RN)

Location: Phoenix, AZ 85012 (Hybrid – Remote after training)

Job Type: Contract (Staff Augmentation)

Duration: 07/27/2026 – 12/31/2026

Schedule: Monday – Friday | 8:00 AM – 5:00 PM | 40 Hours/Week

Interview: In-person (Local Arizona candidates only)

Job Summary:

We are seeking an experienced Registered Nurse (RN) to join as a Quality of Care Investigative Nurse. In this role, you will investigate quality-of-care concerns involving members receiving developmental disability services, ensure compliance with AHCCCS requirements, perform clinical chart reviews, prepare investigation reports, and implement corrective action plans to improve patient care outcomes.

After completing training, the position allows remote work, while maintaining a hybrid work arrangement.

Key Responsibilities:

• Conduct timely and thorough quality-of-care investigations.
• Review medical records, clinical documentation, and case files.
• Identify member-centered and systemic quality-of-care concerns.
• Develop and recommend corrective action plans (CAPs).
• Prepare professional investigation reports and correspondence.
• Maintain complete and accurate investigation documentation.
• Upload required case documentation into the AHCCCS Quality Management System (QMS) Portal.
• Coordinate with oversight and regulatory agencies when necessary.
• Monitor remediation activities and ensure compliance.
• Escalate significant findings and trends to management.
• Participate in assigned Care Concern and member issue investigations.

Required Qualifications:

• Active Arizona Registered Nurse (RN) License.
• 6 months to 1 year of experience in one or more of the following:
• Quality Assurance
• Risk Management
• Clinical Auditing
• Quality Improvement
• Healthcare Compliance
• Experience reviewing medical charts and clinical records.
• Strong analytical, investigative, and documentation skills.
• Proficiency with Microsoft Office and electronic documentation systems.
• Excellent written and verbal communication skills.

Preferred Skills:

• Quality of Care (QOC) investigations.
• AHCCCS or Medicaid experience.
• Corrective Action Plan (CAP) development.
• Healthcare compliance and regulatory knowledge.
• Case management documentation.
• Strong critical thinking and problem-solving abilities.

Work Schedule:

• Monday – Friday
• 8:00 AM – 5:00 PM
• 40 hours per week
• Hybrid (Remote after training)

Candidate Requirements:

• Local Arizona candidates only.
• Must be available for an in-person interview within one week of the posting closing date.
• Must be able to start within two weeks of receiving an offer.
• Must possess a valid Level 1 Arizona Fingerprint Clearance Card.

Required Submission Documents:

• Updated Resume
• Active Arizona RN License
• Level 1 Fingerprint Clearance Card
• Confirmation of local Arizona work location

Location: Phoenix, AZ (Hybrid – Remote after training)

Contract Duration: July 27, 2026 – December 31, 2026