RN jobs in Central Scottsdale, AZ

RN Jobs in Central Scottsdale, AZ

Quality Assurance Nursing Consultant

AHCCCS Arizona Health Care Cost Containment System Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility. AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry. Come join our dynamic and dedicated team. Quality Assurance Nursing Consultant Division of Fee for Service Management (DFSM) Job Location: Phoenix - 150 North 18th Avenue Phoenix, Arizona 85007 Tucson - 7202 East Rosewood Street, Suite 125 Tucson, Arizona 85710 Posting Details: Starting salary at $71,032 and may be increased based on experience and qualifications. FLSA Status: Exempt Grade: 22 Closing Date: Open until filled Job Summary: This position will work independently applying clinical knowledge, judgment, and expertise to assess, coordinate, and monitor service delivery. This position will complete comprehensive assessments of available resources on service providers and individual members; review case material to ensure compliance with State and Federal regulations and policies; and provide timely resolution of multiple cases assigned. This position will also be responsible for identifying systemic issues for AHCCCS to address. This position will be hybrid with some in-office meetings, on-site investigations at least 20% of your time, and reviews as needed. Occasionally, this position may also participate as needed in urgent on-site investigations and reviews outside of normal business hours and weekends. The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance. Major duties and responsibilities include but are not limited to: • Monitor compliance with State and Federal regulations pertaining to quality management processes, tracking, and trending quality of care concerns and/or health and safety/immediate jeopardy concerns. Receive, research, document, and resolve quality of care and/or health and safety issues utilizing standardized processes. Track, trend, and monitor the status of cases to ensure accurate and timely completion and appropriate referrals using a centralized case management tracking database. Ensure research and resolution of issues or concerns promptly as assigned and identify systemic issues for AHCCCS to address. • Contributes clinical knowledge to assist in the resolution of quality of care concerns, clinical reviews and Operational Reviews. Completes an independent review of data management and other deliverables, technical assistance, and focused studies/reviews, including the behavioral health delivery system, to ensure compliance with contractual and policy requirements for all lines of business. Follow-up on written reports, action plans, provider education, and related actions as appropriate. • Conduct on-site investigations regarding possible health and safety concerns, immediate jeopardy situations, and other situations supporting AHCCCS initiatives and ventures. On-site visits may also occur outside of normal business hours and weekends for immediate and urgent situations. • Ensure quality of care to AHCCCS members, including ensuring member dignity and respect, focused on their unique special health care needs, timely correspondence, and resolution of the quality of care concern. Use independent judgment regarding data to research, status level, interventions, and appropriate resolution. • Develop improved processes and procedures to improve the efficiency of the unit. Lead special projects and reviews to ensure completion within the designated timelines. Provide ongoing updates to Management. • Develop metrics for population-specific outcome objectives. Tracking, evaluation, analysis, and revision of metrics as needed based on the ongoing analysis of member data. • Provide education and technical assistance to internal and external stakeholders, as appropriate, regarding covered services, and contractual or policy requirements, accurately and consistently to improve compliance with AHCCCS requirements and improve quality of care and service to AHCCCS members. Knowledge, Skills & Abilities (KSAs): Knowledge of: • State and Federal Policies and Procedures governing Title XIX, Title XXI, Managed Care, and LTC Supports and Services • Current standards of medical/ behavioral practice and modes of delivery for acute and non-acute medical/behavioral care/services • Data management and utilization review regulations, rules and processes • AHCCCS and Medicaid regulations, policies, and procedures and applicable federal and state statutes, regulations and rules • Medical/nursing practice, medical case management protocols, utilization review protocols as related to the acute, LTC, chronic long-term elderly and physically disabled, developmentally disabled, and behavioral/mental health • Case management development, implementation, and ongoing review Skill in: • Acute nursing and clinical processes including assessment, planning, intervention, and evaluation • Clinical assessment skill • Techniques to select a particular approach to analyze develop or implement a policy, project management methodologies, and Behavioral Health delivery system • Problem-solving techniques, evaluation, and initiation of appropriate action • Excellent communication, verbal and written • Organizational skills for setting priorities, workload, and record-keeping • Strong interpersonal skills in working with agency management, and people of diverse cultures and socioeconomic backgrounds • Project management to meet goals and deadlines • Research and analytical skills • Documentation and reporting of data and trends Ability to: • Strong ability to collaborate with others for a mutually beneficial outcome • Interpret clinical information and assess implications for treatment • Read, interpret and apply complex rules and regulations • Independent decision making, yet knowing when to elevate an issue or concern • Assess variables which impact health and functioning • Make effective decisions in a high volume, fast paced environment • Write comprehensive reports Selective Preference(s): Minimum: Must maintain a current Arizona medical license (RN or higher) or Arizona Behavioral Health license (Associate or higher) and 3 years of relevant healthcare experience. May require a valid Arizona Driver License for travel-related duties. Preferred: Experience in Prior Authorization, Utilization Management, claims review, auditing, or managed care; knowledge of population served. Pre-Employment Requirements: • Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions. • Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements. All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify). Benefits: Among the many benefits of a career with the State of Arizona, there are: • 10 paid holidays per year • Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees) • Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child. Learn more about the Paid Parental Leave pilot program here. • Other Leaves - Bereavement, civic duty, and military. • A top-ranked retirement program with lifetime pension benefits • A robust and affordable insurance plan, including medical, dental, life, and disability insurance • Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications) • RideShare and Public Transit Subsidy • A variety of learning and career development opportunities By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion. Learn more about the Paid Parental Leave program here . For a complete list of benefits provided by The State of Arizona, please visit our benefits page Retirement: Lifetime Pension Benefit Program • Administered through the Arizona State Retirement System (ASRS) • Defined benefit plan that provides for life-long income upon retirement. • Required participation for Long-Term Disability (LTD) and ASRS Retirement plan. • Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period). Deferred Retirement Compensation Program • Voluntary participation. • Program administered through Nationwide. • Tax-deferred retirement investments through payroll deductions. Contact Us: Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov. Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.

Per Diem

1 month ago

Registered Nurse RN PRN Days

Oceans Healthcare Phoenix, AZ

Haven Behavioral Healthcare, an Oceans Healthcare Company, is a behavioral healthcare system providing high-quality, specialty behavioral health services for individuals with mental health and substance abuse issues. Our success is a reflection of the excellence and dedication of our employees at every level of our facilities. The culture of our hospitals is built around service. All jobs performed on our team are worthwhile and every employee makes a difference. If you are looking for an opportunity to grow personally and professionally while delivering compassionate, quality care we encourage you to explore career opportunities with Haven. ***We Offer Sponsorships For Registered Nurses*** The Registered Nurse assumes primary leadership accountability and responsibility for milieu management and directing patient care activities of other nursing staff. The Registered Nurse maintains standards of professional nursing practice in accordance with facility policy and procedures, other external governing and credentialing bodies, performance improvement standards, and psychiatric nursing standards. The Registered Nurse assesses the patient utilizing the nursing process to formulate an individualized plan of care for each patient, implements interventions, and evaluates outcomes consistent with policy and appropriate to the current client’s condition, which promote, maintain, and restore physical and mental health, and prevent illness. The Registered Nurse interprets age/disability specific information in response to client population served. The Registered Nurse provides for the safe delivery of medication in accordance with the policies and procedures, physicians orders and/or current practice. The Registered Nurse is responsible for thorough, accurate reporting, and documentation of the patient’s symptoms, responses, and progress. The Registered Nurse assumes responsibility for professional development, continuing education and maintaining licensure. All duties to be done in accordance with Joint Commission, Federal and State regulations, Oceans' Mission, policies and procedures and Performance Improvement Standards. Essential Functions: Utilizes the nursing process: assessment, planning, intervention, implementation, and evaluation and formulating nursing interventions directed towards development of an individualized plan of care and treatment modalities. Identifies risk levels, precautions, and expected outcomes individualized to the client to include discharge planning; prescribes interventions to attain expected outcomes; evaluates the effectiveness of interventions in relation to expected outcomes; conducts ongoing assessment of clients from admission to discharge; initiates medical/psychiatric crisis intervention to stabilize and ensure the well-being of the patient's conditions. Demonstrates knowledge of psychiatric disorders and appropriate nursing interventions; implements nursing interventions identified in the plan of care that is individualized to the patient needs. Applies appropriate interventions to progress the patient towards wellness and addresses maintenance of wellness. Administers medications as prescribed safely; provides education on prescribed medications; recognizes signs and symptoms of adverse drug reactions. Demonstrates professionalism, accountability, and responsibility for decision making, quality nursing care, and knowledge base of psychiatric nursing care. Reviews, revises, and updates medical records within facility guidelines and timeframes. Transcribes and implements physician's orders according to facility policy; documents care, progress, response to intervention in medical record in an accurate, thorough and concise manner. Follows up on client care responsibilities, communicates incomplete assignments, and current client needs to staff to assure continuity of care. Implements staff assignments and delegation of duties using appropriate judgment and knowledge; Demonstrates positive willingness to assist staff and patients; functions as an advocate for patient needs/safety Utilizes nursing knowledge to successfully meet the needs of the facility, patient population, and staff members utilizes nursing resources to enhance evidence-based practice Float among various clinical services, where qualified and competent and performs other duties and projects as assigned.