Licensed Practical Nurse

Job Description

Job Description – LPN Quality of Care Investigative Nurse

Remote – Arizona Local Candidates Only

Location: Phoenix, AZ

Work Mode: Remote (First day onsite for equipment pickup and security training)

Contract Duration: 1 month and 15 days (approximately 1.5 months).

Working Hours: Monday–Friday, 8 AM–5 PM

Hours per Week: 40 Hours

Job Summary:

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

The primary responsibility is to investigate member-related and systemic quality-of-care concerns, review medical records, analyze clinical information, identify inconsistencies, and prepare detailed investigative reports.

The ideal candidate should have strong clinical knowledge combined with experience in quality assurance, risk management, medical chart reviews, auditing, and investigative report writing.

This position is more focused on investigation, research, documentation, and quality assurance than direct bedside patient care.

Key Responsibilities:

• Conduct thorough 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 appropriate 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.
• Participate in Care Concerns, Care Needed Today, and other assigned member issues.

Required Qualifications:

1. Active LPN license in the State of Arizona.
2. High School Diploma or equivalent.
3. 6 months to 1 year of experience in one or more of the following:

• Risk Management
• Quality Assurance Nursing
• Clinical Auditing
• Healthcare Compliance
• Quality-of-Care Reviews

1. Experience analyzing complex cases and reviewing extensive medical records.
2. Ability to identify inconsistencies and develop evidence-based conclusions.
3. Strong critical-thinking and clinical judgment skills.
4. Excellent professional report-writing and documentation skills.
5. Experience with medical chart reviews and clinical documentation.

Preferred Qualifications:

• BSN, MSN, or doctoral-level nursing education.
• Experience preparing formal investigative reports.
• Experience in healthcare quality assurance and risk management.
• Clinical auditing and utilization review experience.
• Regulatory compliance and patient safety experience.
• Experience evaluating compliance with clinical standards.
• Experience developing corrective action plans.

Compliance Documents Required:

• Updated Candidate Resume
• Level 1 Fingerprint Clearance Card (Front and Back)
• Active Arizona LPN License
• CPR/BLS Card
• TB Skin Test
• Driver's License