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INVESTIGATIVE NURSE

$66k - $78k
Full-time

State of Arizona

:

DEPARTMENT OF ECONOMIC SECURITY

Your Partner For A Stronger Arizona. DES works with families, community organizations, advocates and state and federal partners to realize our collective vision: A thriving Arizona. DES serves more than 3 million Arizonans. Our Mission is to strengthen individuals, families, and communities for a better quality of life.

INVESTIGATIVE NURSE

Job Location:

Address: Division of Developmental Disabilities (DDD) 4000 North Central Avenue, Phoenix, Arizona 85012

Posting Details:

Salary: $66,000.00 - $78,000.00

Grade: 22

Closing Date: November 29, 2025

Job Summary:

The Department of Economic Security, Division of Developmental Disabilities (DDD), is seeking an experienced and highly motivated individual to join our team as a QA Investigative Nurse. DDD provides individuals with developmental disabilities, and their families, services and supports that are flexible, high quality, and member driven. These services provide individuals with opportunities to exercise their rights and responsibilities of independent decision-making and engagement in the community. Applicants for this position cannot be licensed or certified by the DDD Office of Licensing Certification and Regulation, cannot have a principal interest in or have spouse or close family with principal interest in a DDD Qualified Vendor Agreement, and cannot be employed or subcontracted by a DDD Qualified Vendor.

This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.

The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State's Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.

Job Duties:

Essential Duties and Responsibilities include but are not limited to:
  • Conducts timely and thorough member-centric and systemic investigations for all division member quality of care issues and places vendor specific corrective action plans in place utilizing standardized process. Makes appropriate referrals to oversight and regulatory agencies. Participates in Care Concerns, Care Needed today member issues as assigned.
  • Conducts tracking and trending of member-centric and systemic Quality of Care (QOC) issues and vendor specific Corrective Action Plan resolution results in division databases and in the Arizona Health Care Cost Containment System (AHCCCS) Quality Management System (QMS) Portal. Appropriately elevates cases and/or trend concerns to QOC supervisor.
  • Maintains all necessary documentation to support case work. Request appropriate documentation for quality of care investigations and ensures maintenance of comprehensive case records to support allegation review and substantiation levels.
  • Participates in Peer Review Meetings, technical assistance, focused audits/ reviews to ensure compliance with contractual and policy requirements. Ensures all work is in alignment to AHCCCS policies.

Knowledge, Skills & Abilities (KSAs):

Knowledge in:
  • Applicable Laws, rules, policies, procedures, and standards related to acute care delivery, nursing scope of practice and quality management and principles and practices of case management.
  • Project management principles and professional report and technical writing principles.
  • General Laws and reporting regulations for abuse and neglect of vulnerable populations.
  • Health care issues and standards of care for vulnerable populations including developmentally disabled and /or those receiving long term services.
  • Quality Management and Utilization Management Processes.
Skills In:
  • Use of data bases, Microsoft Office products, email, and electronic referral and verification sources.
  • Research and analysis. Personal planning, organization, and time management.
  • Medical chart review.
  • Nursing process including assessment, monitoring, and evaluation.
  • Decision making skills.
  • Strong interpersonal skills in order to effectively relate to AHCCCS members, their families, and Agency stakeholders.
Ability to:
  • Interpret rules, laws, and policies and apply to unique case circumstances.
  • Work in a fast-paced environment.
  • Organize, prioritize, and track files and information from various sources.
  • Work independently and with a variety of internal and external customers.
  • Accommodate changing requirements or standards.

Selective Preference(s):

The ideal candidate for this position will have:
  • One (1) year of experience working with Intellectual Disability population.

Pre-Employment Requirements:

  • Required at time of appointment: possession of a current license to practice as a registered nurse in the State of Arizona
  • If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver's License Requirements. Any employee operating a motor vehicle on State business must possess and retain a current, valid class-appropriate driver's license, complete all required training, and successfully pass all necessary driver's license record checks. The license must be current, unexpired, and neither revoked nor suspended. Employees who drive on state business are subject to driver's license record checks, must maintain acceptable driving records, and must complete all required driver training. An employee who operates a personally owned vehicle on state business shall maintain the statutorily required liability insurance (see Arizona Administrative Code (A.A.C.) R2-10-207.11).
  • Successfully pass background and reference check; employment is contingent upon completion of the above-mentioned process and the Agency's ability to reasonably accommodate any restrictions.
  • All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
Employee shall have a valid Level One fingerprint clearance card issued pursuant to Arizona Revised Statute 41-1758.07 in order to work with children and vulnerable adults.
  • Candidates for this position shall be subject to a search of the Child Protective Services Central Registry pursuant to A.R.S. 8-804.

Benefits:

The Arizona Department of Economic Security offers a comprehensive benefits package to include:
  • Affordable medical, dental, life, and short-term disability insurance plans
  • Participation in the Arizona State Retirement System (ASRS) and long-term disability plans
  • 10 paid holidays per year
  • Vacation time accrued at 4.00 hours bi-weekly for the first 3 years
  • Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
  • Sick time accrued at 3.70 hours bi-weekly
  • Deferred compensation plan
  • Wellness plans
  • Tuition Reimbursement
  • Stipend Opportunities
  • Infant at Work Program
  • Rideshare and Public Transit Subsidy
  • Career Advancement & Employee Development Opportunities
  • Flexible schedules to create a work/life balance

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Retirement:

State employees are required to participate in the Arizona State Retirement System (ASRS), the State sponsored retirement contribution plan and the Long-Term Disability (LTD) program after a 27-week waiting period. The ASRS defined benefit plan provides for life-long income upon retirement. You will also have the option to participate in a voluntary deferred compensation program to take advantage of tax-deferred retirement investments. On, or shortly after, your first day of work you will be provided with additional information about the available insurance plans, enrollment instructions, submission deadlines and effective dates.

Contact Us:

For questions about this career opportunity, please contact Paul Sharp at View phone number on us.edajobs.com or View email address on us.edajobs.com. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting Paul Sharp at View phone number on us.edajobs.com or View email address on us.edajobs.com. Requests should be made as early as possible to allow time to arrange the accommodation.

Vacancy posted 6 days ago
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