Remote LPN: Quality-of-Care Investigator

I3 INFOTEK INC; Phoenix (AZ); Hybrid; USD 34,000 - 52,000; Full time

Job summary

I3 INFOTEK INC in Phoenix, AZ is seeking an LPN Quality of Care Investigative Nurse to join the Quality Management Unit. The role centers on investigating member-related and systemic quality concerns, reviewing medical records, and producing defensible investigative reports.

The ideal candidate has an AZ LPN license, 6–12 months in quality assurance or clinical auditing, strong critical thinking, and superb documentation skills.

Qualifications

• 6–12 months of experience in quality assurance, clinical auditing, or quality-of-care reviews.
• Strong critical-thinking and clinical judgment required.
• Excellent professional report-writing and documentation.
• Experience with medical chart reviews and clinical documentation.
• Ability to identify inconsistencies and develop evidence-based conclusions.

Responsibilities

• Conduct investigations of member-related and systemic quality-of-care concerns.
• Review medical records, clinical documentation, and supporting evidence.
• Analyze complex cases and identify inconsistencies, patterns, and potential quality issues.
• Collect and evaluate information from multiple sources.
• Prepare detailed, professional, and defensible investigative reports.
• Maintain comprehensive documentation and case records.
• Identify corrective actions and develop Corrective Action Plans (CAPs).
• Upload investigative documentation into the AHCCCS Quality Management System (QMS) Portal.
• Escalate significant cases and recurring concerns to the QOC Supervisor.
• Coordinate referrals to appropriate oversight and regulatory agencies.

Skills

Critical thinking

Clinical judgment

Report writing

Medical chart reviews

Data analysis

Education

Licensed Practical Nurse (LPN) in AZ

High School Diploma or equivalent

Job description

I3 INFOTEK INC in Phoenix, AZ is seeking an LPN Quality of Care Investigative Nurse to join the Quality Management Unit. The role centers on investigating member-related and systemic quality concerns, reviewing medical records, and producing defensible investigative reports.

The ideal candidate has an AZ LPN license, 6–12 months in quality assurance or clinical auditing, strong critical thinking, and superb documentation skills.