RN Quality of Care | Behavioral Health | Remote (PHX)

Banner Health

Phoenix (AZ)

Hybride

USD 47 000 - 78 000

Plein temps

Il y a 12 jours

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Résumé du poste

Banner Health is seeking an RN Quality of Care professional to review medical records for quality of care cases, investigate concerns via the AHCCCS portal, ensure compliance, and support member safety. You will triage referrals, collaborate with providers and internal teams, and may travel for onsite health and safety visits in the Phoenix metro area to ensure members receive safe and appropriate care.

The position is on-site during orientation, with initial training conducted via Teams (eight

Qualifications

Two years of clinical experience in an acute care or outpatient setting.
RN license in state of practice.
Knowledge of National Medicare and State AHCCCS regulations.
Excellent written and verbal communication skills.
Ability to work independently to identify, develop, monitor and report quality indicators.

Responsabilités

Investigates referred Quality of Care concerns, including medical record reviews and provider responses.
Prepares Quality of Care cases and presents them to Medical Director for review.
Supports development and implementation of QA training programs.
Communicates monitoring results to QM leadership and QOC team.
Identifies potential risk management and compliance issues during the review process.