Clinical Quality & Compliance Coordinator

Arizona Department of Administration; Phoenix (AZ); Hybrid; USD 64,000 - 78,000; Full time

Benefits offered by this job

10 paid holidays

Pension program

Health insurance

RideShare/Public Transit Subsidy

Learning and career development

Job summary

AHCCCS, Arizona Health Care Cost Containment System, seeks a Clinical Quality Management Coordinator to lead complex reviews, coordinate service delivery, and ensure adherence to state and federal rules. This role blends clinical expertise with policy interpretation in a hybrid work setting within Arizona.

Based in the Office of the Director, the position involves on-site investigations, data analysis, and collaboration across teams to improve quality and safety for AHCCCS members.

Qualifications

• Must maintain a current Arizona medical license (RN or higher), and 3 years of relevant healthcare experience.
• Experience in managed care, quality management, utilization management, or social work preferred.
• Pre-employment requirements include background checks, driver training if driving on state business, and E-Verify compliance.

Responsibilities

• Monitor compliance with State and Federal quality management regulations; track, research, document, and resolve quality of care issues.
• Contribute clinical knowledge to resolve quality of care concerns and conduct reviews and studies to ensure regulatory compliance.
• Ensure quality of care for AHCCCS members with clear, timely communication and appropriate resolution of issues.

Skills

Clinical assessment

Communication

Project management

Data analysis

Problem solving

Organization

Interpersonal skills

Collaboration

Independent decision making

Documentation

Education

Arizona medical license (RN or higher)

Job description

AHCCCS, Arizona Health Care Cost Containment System, seeks a Clinical Quality Management Coordinator to lead complex reviews, coordinate service delivery, and ensure adherence to state and federal rules. This role blends clinical expertise with policy interpretation in a hybrid work setting within Arizona.

Based in the Office of the Director, the position involves on-site investigations, data analysis, and collaboration across teams to improve quality and safety for AHCCCS members.