New

Quality Improvement Coordinator II

Spectraforce Technologies
United States, North Carolina, Raleigh
500 West Peace Street (Show on map)
Dec 17, 2025
Position Title: Quality Improvement Coordinator II Work Location: Remote AZ - MUST RESIDE IN AZ Assignment Duration: 3 months Work Schedule: M-F, 8:00 AM - 5:00 PM (AZ time) Work Arrangement: Remote (Arizona residents only) Position Summary: Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communication with agencies and providers. Background & Context: Collaborative culture supporting quality oversight activities and completion of AHCCCS Medicaid Quality of Care (QOC) investigations. Key Responsibilities: Conduct review of delegated entities for compliance with quality, service performance and utilization Perform credentialing reviews and medical record audits Perform community activities related to clinical initiatives such as health fairs Communicate with agencies and providers Receive 1-2 QOC investigations daily with 60-day turnaround Review medical records, provider policies/manuals and statutes Write investigative reports of findings and submit reports Develop quality improvement plans to address provider quality concerns Complete approximately one investigative report per day Qualification & Experience: Bachelor's degree in nursing or licensed counselor/social worker preferred LPN, LVN, RN, PA, LPC, LAC or LCSW license preferred CPHQ (Certified Professional in Healthcare Quality) preferred 3+ years of clinical, quality improvement or healthcare experience 2+ years of experience in a quality function in a healthcare setting MUST have behavioral health or physical health setting experience Clinical knowledge Critical thinker, able to work independently, tech savvy Self-driven and fast learner Working Conditions & Physical Demands: Remote role with computer-based work Teams video interviews with camera on Computer literacy testing required