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1 hour ago
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Full time
Salary
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utilization review rn registered nurse regulatory compliance healthcare auditing

πŸ“‹ Description

  • Lead, direct, and oversee the Quality Assurance Nurse Investigations Unit, including recruitment
  • Ensure unit operations comply with established Office of Inspector General standards, policies
  • Apply advanced clinical expertise to guide complex medical investigations, ensuring accuracy
  • Serve as a key liaison with the Inspector General, Deputy Assistant Directors, Deputy Inspectors
  • Coordinate responses to external audits, reviews, and formal inquiries, ensuring that information
  • Contribute to the development and implementation of strategic plans, annual goals, and operational

🎯 Requirements

  • An active Registered Nurse (RN) license, or higher, issued by the Arizona State Board of Nursing
  • An Arizona driver's license.
  • Strong knowledge of clinical record reviews, healthcare data analysis, medical necessity, and
  • Understanding of investigative techniques, interviewing, evidence assessment, audit processes, and
  • Knowledge of Medicaid and Medicare regulations, including Title 19, AHCCCS rules, and provider and
  • Familiarity with applicable federal and Arizona laws, including Arizona Revised Statutes Titles 13

🎁 Benefits

  • Annual salary: $100,000–$110,000.
  • Remote work options, with full-time or part-time remote schedules subject to management approval
  • 10 paid holidays per year.
  • Paid vacation, starting at 13 days annually.
  • Paid sick leave, starting at 12 days annually.
  • Up to 12 weeks of paid parental leave for eligible employees following the birth or placement of a
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