LPN​/LVN - General

Profession: LPN

Specialty: Staff Augmentation

Duration: 12 months

Shift: Day

Hours per Shift: 8:00 AM - 5:00 PM

Experience: Minimum years of experience required

License: Active license to practice as an LPN in the state of Arizona

Certifications: Level 1 Fingerprint Clearance Card

Must-Have:

• Critical thinking skills
• Technological skills, including the use of databases, Microsoft Office products, email, and electronic referral and verification sources
• Ability to produce professional technical reports and letters
• Skills in research and analysis
• Strong oral and written communication skills
• Personal planning, organization, and time management skills
• Proficiency in medical chart review
• Knowledge of the nursing process, including assessment, monitoring, and evaluation
• Decision-making skills

Description:

This position reports to the Quality Management Unit.

The role involves conducting quality-of-care investigations.

Investigations are pursuant to contractual obligations.

You will participate in investigations of member-centric and systemic quality-of-care concerns.

The goal is to ensure member health and well-being.

You will conduct timely, thorough, member-centric, and systemic investigations of quality-of-care issues.

Utilize a standardized process to implement vendor-specific corrective action plans.

Make appropriate referrals to oversight and regulatory agencies.

Participate in assigned care concerns and member issues.

You will maintain all necessary documentation to support case work.

Request appropriate documentation for quality-of-care investigations.

Ensure the maintenance of comprehensive case records to support allegation review and substantiation levels.

At the conclusion of investigations, issue remediation or corrective action plans as necessary.

Ensure all relevant investigative information and documents are uploaded to the required portal.

Appropriately elevate cases and/or trend concerns to the quality of care supervisor.