Quality Improvement Coordinator

Work Mode: 100% Remote AZ – CANDIDATE MUST RESIDE IN AZ
Duration: 90 days (possible extension and/or conversion)
SHIFT: Training M-F 8-5p – 1on1 setting – 4 weeks – no time off. Regular Schedule: M-F 8-5p AZ

Responsibilities:

• Conduct review of delegated entities for compliance with quality, service performance, and utilization.
• Perform credentialing reviews and medical record audits.
• Engage in community activities related to clinical initiatives such as health fairs and communication with agencies and providers.
• Complete AHCCCS Medicaid QOC investigations.
• Receive 1-3 QOC investigations daily that are due 60 days from the assignment date.
• Review medical records, provider policies/manuals, and statutes to ensure appropriate care per guidelines.
• Write and submit investigative reports of findings.
• Develop quality improvement plans to address concerns with providers.
• Utilize systems such as Word, Teams, Outlook, PowerPoint, Excel, OneDrive, OneNote & specialized report systems.

Requirements:

• Bachelor’s degree in nursing or license (COMPACT IS OK) preferred.
• LPN, LVN, RN, PA, LPC, LAC or LCSW license preferred.
• CPHQ (Certified Professional in Healthcare Quality) preferred.
• Minimum 3 years of clinical, quality improvement, or healthcare experience.
• MUST have experience in a BH or physical health setting.
• Minimum 2 years of experience in a quality function in a healthcare setting.

Preferred Skills:

• Clinical knowledge.
• Critical thinker, independent work, tech savvy.
• Self-driven, fast learner.