Health Plan Behavioral Health Quality Of Care Registered Nurse

Banner Medical Group

Phoenix, Arizona, United States
Base: $33.11 - $55.18 ph; bonus/equity: not specif...
Hybrid
Current valid rn license in arizona
Two years acute or outpatient clinical experience
One year quality management experience
This role involves investigating quality of care concerns for Banner University Health Plan members through medical record reviews and provider communication

Job Summary

  • This role involves investigating quality of care concerns for Banner University Health Plan members through medical record reviews and provider communication.
  • The position requires presenting cases to Medical Directors and coordinating with a cross-functional team including LMSWs to ensure member safety and care quality.
  • Banner Plans & Networks offers a remote hybrid work model with occasional on-site visits while maintaining a strong focus on work/life balance.

Matching Summary

This role involves investigating quality of care concerns for Banner University Health Plan members through medical record reviews and provider communication.

Salary

Base: $33.11 - $55.18 per hour; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Current valid RN license in Arizona
  • Two years acute or outpatient clinical experience
  • One year quality management experience
  • Knowledge of Medicare and AHCCCS regulations
  • Strong chart review and data analysis skills

Nice-to-have

  • CPHQ certification preferred
  • Remote hybrid work environment
  • Collaborative team-oriented culture
  • Experience with behavioral health statutes

Key Requirements

  • Valid RN license in state of practice
  • Minimum two years clinical experience
  • At least one year quality management role
  • Knowledge of national Medicare regulations
  • Knowledge of State AHCCCS regulations

Work Rights

Phoenix, Arizona Metro residency required

Tailored Resume

Cover Letter