Quality Improvement Coordinator

Summary:

• Location: 100% Remote- Nevada- Must reside in Nevada
• Work Mode: Remote
• Duration: 90 days with potential to extend or convert
• Shift: Training Schedule M-F 8-5p – 1on1 setting – 4 weeks – no time off
• Work Schedule: M-F 8-5p AZ

Responsibilities:

• Conduct review of delegated entities for compliance with quality, service performance, and utilization, credentialing reviews, and medical record audits.
• Perform 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, due 30 days from the assignment date.
• Review medical records, provider policies/manuals, and statutes to ensure appropriate care is rendered to members per guidelines.
• Write and submit an investigative report of findings.
• Develop quality improvement plans to address quality concerns with providers.

Requirements:

• Required: Any type of Nursing license
• Minimum 3 years of clinical, quality improvement, or healthcare experience.
• Minimum 2 years of experience in a quality function in a healthcare setting.
• Must have Behavioral Health (BH) or physical health setting experience.

Preferred Skills:

• Preferred: Bachelor’s degree in nursing or licensed counselor/social worker.
• Preferred: RN license.
• Clinical knowledge
• Critical thinker, independent work, tech-savvy
• Self-driven, fast learner

Benefits:

• Collaborative culture
• Opportunity to work on key projects