Registered Nurse

I3 INFOTEK INC; Phoenix (AZ); Hybrid; USD 70,000 - 100,000; Part time

Job summary

I3 INFOTEK INC. is seeking a Registered Nurse (RN) for a Quality of Care Investigative role, focusing on complex member-related and systemic quality concerns. You'll review medical records, analyze evidence, and prepare professional reports within a Quality Management Unit.

The position emphasizes investigative reasoning, data interpretation, and documentation rather than bedside care. Hybrid arrangement allows primarily remote work with initial onsite onboarding in Phoenix, AZ.

Qualifications

• Active Arizona RN license with strong clinical judgment.
• Experience reviewing medical charts and clinical documentation.
• Ability to investigate complex healthcare cases and reach evidence-based conclusions.
• Strong written and verbal communication and professional report-writing.
• Proficiency in Microsoft Office and electronic healthcare systems.

Responsibilities

• Conduct thourough investigations into member-centric and systemic quality-of-care concerns.
• Review medical records, clinical documentation, and healthcare-related reports.
• Analyze information from multiple sources and identify inconsistencies and care deficiencies.
• Gather and evaluate supporting documentation for investigations.
• Determine substantiation levels for reported allegations.
• Prepare detailed, professional, and defensible investigative reports.
• Develop and issue corrective action plans (CAPs) to healthcare vendors when necessary.
• Upload investigative documentation into AHCCCS QMS Portal.
• Identify cases needing escalation and communicate concerns to supervisor.
• Refer cases to regulatory and oversight agencies when appropriate.
• Participate in Care Concerns and other member-related investigations.
• Maintain accurate and comprehensive case documentation.

Skills

Quality Assurance

Clinical Auditing

Regulatory Compliance

Investigation

Medical Records Review

Report Writing

Microsoft Office

Education

Bachelor's degree in Nursing (BSN)

Master's degree or Doctoral-level education

Tools

Electronic Health Records (EHR) systems

AHCCCS QMS Portal

Job description

Job Description – Registered Nurse (RN) – Quality of Care Investigative Nurse

Work Arrangement: Hybrid (Primarily Remote)

Contract Duration: (approximately 2.5 months)

Working Hours: 40 hours/week

Schedule: Monday–Friday, 8 AM–5 PM

Travel: Not Required

First Day Onsite for equipment collection and security training Remaining Work Primarily Remote

Job Summary

The Quality of Care Investigative Nurse will work within the Quality Management Unit.

The primary responsibility is to investigate member-related and systemic quality-of-care concerns, review medical records, identify potential gaps in care, analyze evidence, and prepare detailed investigative reports.

The ideal candidate should have strong nursing knowledge combined with experience in quality assurance, risk management, clinical auditing, utilization review, regulatory compliance, or patient safety.

This role focuses more on investigation, analytical skills, and professional report writing than direct bedside patient care.

Key Responsibilities

• Conduct thorough investigations into member-centric and systemic quality-of-care concerns.
• Review medical records, clinical documentation, and healthcare-related reports.
• Analyze information from multiple sources and identify inconsistencies, trends, and potential care deficiencies.
• Gather and evaluate supporting documentation for investigations.
• Determine the appropriate level of substantiation for reported allegations.
• Prepare detailed, professional, and defensible investigative reports.
• Develop and issue corrective action plans (CAPs) to healthcare vendors when necessary.
• Upload investigative documentation and findings into the AHCCCS Quality Management System (QMS) Portal.
• Identify cases requiring escalation and communicate concerns to the QOC Supervisor.
• Make appropriate referrals to regulatory and oversight agencies.
• Participate in Care Concerns, Care Needed Today, and other assigned member-related investigations.
• Maintain accurate and comprehensive case documentation.

Required Qualifications

• Active Arizona Registered Nurse (RN) license.
• Strong clinical judgment and critical-thinking skills.
• Experience reviewing medical charts and clinical documentation.
• Ability to investigate complex healthcare cases.
• Ability to analyze information from multiple sources and reach evidence-based conclusions.
• Strong written and verbal communication skills.
• Professional report-writing and documentation skills.
• Proficiency in Microsoft Office, databases, email, and electronic healthcare systems.

Preferred Qualifications

• Bachelor's degree in Nursing (BSN), Master's degree, or Doctoral-level education.
• 6 months to 1 year of experience in any of the following:
• Quality Assurance (QA)
• Clinical Auditing
• Quality-of-Care Reviews
• Regulatory Compliance
• Experience preparing formal investigative reports.
• Experience conducting clinical research.
• Experience evaluating healthcare compliance with clinical standards.
• Experience analyzing complex cases involving extensive medical records and supporting evidence.