Employment Type: Full time
Shift: Day Shift
Description
At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work, and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care.
The Peer Review Coordinator is responsible for accurate collection, analysis, and reporting of data as it relates to performance improvement activities, provider peer review, and data used in consideration for appointment/reappointment. Maintains and coordinates the entire Physician Peer Review process regarding information control and direct one-on-one communication. Analyzes data regarding current and past case reviews and subsequent requested reports, and integration of Peer Review process with medical Records processes. Communicates to and from all physicians and their Office of Medical Affairs and Medical Records Services, and coordinates with members of the Performance Improvement department. Functions effectively within a team of performance improvement professionals.
Schedule: M - F // 5 8 hr shifts or 4 10hr shifts
*1 remote day a week, once fully trained.
SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE
- Licensed RN in Idaho.
- Minimum 3 years of experience working with physicians and clinical staff.
- BSN preferred, or 8+ years of professional RN experience.
- Inpatient clinical experience and project management skills preferred.
- Familiarity with a wide range of medical specialties and acute care settings is a plus.
ESSENTIAL FUNCTIONS
- Works with Risk Management to facilitate focused peer reviews for physician cases. Works with Medical Staff Office to coordinate focused professional practice evaluations and ongoing professional practice evaluations when physicians' quality of care is questionable.
- Uses clinical expertise to review care documented in the medical record for the purpose of identifying practice/events that fall outside established standards of care.
- Participates in medical staff department and committee meetings to exchange information and ensure consistency across all medical staff departments.
- Determines if peer review is indicate and/or enlists the appropriate parties to address any non-peer review issues.
- Assists in facilitating quality improvement efforts through identification and validation of data elements for the medical staff and health system.
- Identifies and investigates medical staff complexities and issues as it pertains to patient care and involve appropriate stakeholders for policy changes and/or actionable items.
- Ensures the work of the department meets the accreditation and regulatory requirements for peer review including but not limited to ongoing professional practice evaluation.
- Serves as a resource to others in the resolution of complex problems and issues pertaining to provider peer review.
- Facilitates and coordinates all medical staff peer review committee(s) to the appropriate medical staff/provider audiences.
- Performs other duties and responsibilities as assigned.
- Oversees/verifies production of peer review dashboards and physician reappointment data, with the Data Team.
- Provides team members with all required documentations for Medical department meetings (e.g. locations of required charts, current status reports, history of reviews).
- Maintains the peer review database – ensures data integrity.
- Works with medical staff department chairs, Credentials and Office of Medical Affairs to coordinate the aforementioned functions.
- Oversees peer review related dashboard indicators.
- Maintains confidentiality per Idaho Code 39-1392.Develops visual display of data and control charts
- Uses, reviews, and evaluates lab results, diagnostic studies, and medication administration.
- Sound understanding of all federal and state regulations including JHACO compliance.
- Ability to measure and evaluate data, including methods to track implementation of action plans.