• Registered Nurse RN Quality Behavioral Health

    Job Number
    228974
    Facility
    Univ Physicians Health Plans
    Department
    HP Statewide Quality
    Address : Location
    US-AZ-Tucson
    Work Schedule
    Day
    Position Type
    FT: Full-Time
    Posting Category
    Quality
  • ---

    At Banner Health, we believe that “leadership matters” and is a key component to providing excellent patient care. Join a nationally recognized leader that values excellence, and begin making a difference in people’s lives.

      

    As a Quality of Care Behavioral Health RN, you will support our Banner Health Plans. It is essential for this role to have behavioral health and quality management experience.  Banner Health has been awarded a new contract, AHCCCS Complete Care- a plan that will be focused on the integration of physical health, behavioral health, and social determinants of health beginning. We are known nationally as an innovative leader in new health care models, where insurance plans and physicians come together to work collaboratively to make things easier for the member. The division serves over 500,000 members in our community. Join a team that strives to provide patients a safe, supportive environment that fosters healing and facilitates a return to the highest possible level of independence.  

     

    Schedule - 7am-4pm or 8am-5pm

    Opportunities to work remote 2-3 days a week!

     

    Location:

    Banner Corp Mesa

    525 W Brown RD

    Mesa, AZ 85201

     

    OR

     

    Banner Corp Tucson

    2701 E Elvira RD

    Tucson, AZ 85756

     

    Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.

    ---

    About University Physicians Health Plans
    The University of Arizona Health Plans (UAHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care.

     

    Truven-2013
    Stage7-2013

    About Banner Health
    Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

    ---

    Job Summary

    The primary purpose of this position is to coordinate the investigation of quality of care concerns that have been referred to the Quality Management Department for review and resolution. The position is also responsible for assisting with education and training of health plan staff on the quality review process.

     

    Essential Functions

    • Investigates referred Quality of Care concerns, including medical record documentation review, obtaining provider responses, preparation of acknowledgment and closure correspondence, tracking cases in database. Assists in preparation of Quality of Care reporting

     

    • Prepares Quality of Care cases for Peer Review as necessary and presents cases to Medical Director for review.

     

    • Participates in the collection and maintenance of data appropriate to the Quality Improvement Program. Implements and tracks provider corrective actions as necessary.

     

    • Participates in the preparation of routine and special reports, including the quarterly report, to the UAHN Board of Directors.

     

    • Assist in the development and implementation of the Organization wide UAHP Quality of Care training program.

     

    • Communicates the results of the monitoring and evaluation process to relevant individuals, or departments.

     

    • Identifies potential risk management and peer review problems in process of quality review for referral to the Risk Management and other appropriate staff.

     

     

    Minimum Qualifications

    Two years of clinical experience in an acute care setting; at least one year of quality improvement experience in an outpatient or inpatient setting and strong healthcare knowledge is also required.

    Must possess a current, valid RN license in state of practice

    Knowledge of National and State Ambulatory and Acute Care Quality Improvement requirements and guidelines for JCAHO, NCQA, HEDIS, HCFA, and AHCCCS is required. Excellent written and verbal communication skills, strong analytical, problem solving, concurrent and retrospective data management and computer skills are necessary.

    The ability to identify variances from protocol and the ability to work independently to identify, develop, monitor, evaluate, report and perform ongoing, objective, cyclic, and systematic QI indicator data, and the ability to establish good working relationships with all levels of UAHP support staff, providers, administrative staff and all other internal and external customers. Ability to make professional presentations to department heads, section chiefs, and to outside professional organizations is needed.

    Preferred Qualifications

    A B.S.N. is preferred.

    Additional related education and/or experience preferred.

    Connect With Us!

    Join one of our Talent Communities to learn more about a career at Banner Health.