Provider Quality and Compliance Coordinator RN

Lake Charles Memorial Hospital•Lake Charles, LA

About The Position

DESCRIPTION OF POSITION: The professional Practice Evaluation (PPE) Coordinator organizes, oversees and performs support functions for Medical Staff PPE for all the LCMH Medical Staff. They are also responsible for facilitating the peer review process. This role ensures timely, accurate, and confidential review of clinical care, facilitates PPE and collaborates with medical staff leadership, quality, and risk management. SUPERVISION: Reports directly to the Chief Medical Officer. RESPONSIBILITIES AND DUTIES: Maintains strict adherence to the tenets of Medical Staff Professional Practice Evaluation/ Peer Review and to maintain confidentiality of all discussions, records, data, correspondence and PHI. Coordinates and facilitates an accurate, organized and timely process for Medical Staff PPE including Peer Review. Serves ad Medical staff liaison for PPE activities Performs chart reviews as part of the PPE process Participates in the development and reporting of data regarding PPE activities for the purpose of credentialing and for identification of trends and patterns. Prepares materials required by the Medical Staff to conduct PPE Meets Deadlines Collaborates with all clinical team members during case review Reports Concerns about clinical quality and patient safety, including related to behavioral issues, to appropriate leadership in a timely manner. Maintains knowledge of, supports compliance with, and assists in preparation for surveys related to organizational, regulatory and certification requirements that apply to and guide Medical Staff PPE at all locations. Develops and maintains collaborative relationships with Quality and Patient Safety, HIM/Medical Records Staff, Human Resources, Patient Care Management Staff, and others for the purpose of enhancing program effectiveness. Participates in identifying and assisting in developing policies, procedures and processes in PPE functions. Works independently and adapts to frequent changes in PPE and related processes Effectively utilizes all computer systems needed to perform essential functions. Simultaneously handles multiple electronic systems as needed. SKILLS: Ability to work with Medical Staff leaders and administrative personnel. Ability to maintain confidentiality of patient medical information and Medical Staff information. Ability to understand and ensure adherence to requirements including medical legal standards, laws, and regulatory requirements. Ability to communicate verbally and in writing with Medical Staff leaders, Administration and others. Ability to lead groups, facilitate consensus, maintain communication, and direct action. Ability to think analytically and to inform data collection, analysis and reporting approaches. Ability to prioritize work assignments and adapt to changing processes. Ability to read and analyze data. Ability to understand regulations. Ability to work with minimal supervision. Strong Organizational and interpersonal skills. Proficiency in MS office software. The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description . EDUCATION AND WORK EXPERIENCE Graduate of School of Nursing Current Louisiana Registered Nurse license or compact state license as Registered Nurse Minimum of 2-5 years experience. Preferred experience in quality, peer review, risk management or medical staff services. Physical Demands/Work Environment Work requires a variety of physical activities including sitting, standing and walking. Bending, stooping, and lifting are minimal. The work environment may be physically confining. Must have normal hearing or utilize adaptive hearing devices if duties require listening with a stethoscope to discern breath sounds, heart sounds, and bowel sounds. Visual acuity required for a variety of activities. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Experience Memorial is more than a slogan, its the care we provide our patients and its the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated. Working at Lake Charles Memorial Health System | Great Place To Work

Requirements

Graduate of School of Nursing
Current Louisiana Registered Nurse license or compact state license as Registered Nurse
Minimum of 2-5 years experience.
Ability to work with Medical Staff leaders and administrative personnel.
Ability to maintain confidentiality of patient medical information and Medical Staff information.
Ability to understand and ensure adherence to requirements including medical legal standards, laws, and regulatory requirements.
Ability to communicate verbally and in writing with Medical Staff leaders, Administration and others.
Ability to lead groups, facilitate consensus, maintain communication, and direct action.
Ability to think analytically and to inform data collection, analysis and reporting approaches.
Ability to prioritize work assignments and adapt to changing processes.
Ability to read and analyze data.
Ability to understand regulations.
Ability to work with minimal supervision.
Strong Organizational and interpersonal skills.
Proficiency in MS office software.

Nice To Haves

Preferred experience in quality, peer review, risk management or medical staff services.

Responsibilities

Maintains strict adherence to the tenets of Medical Staff Professional Practice Evaluation/ Peer Review and to maintain confidentiality of all discussions, records, data, correspondence and PHI.
Coordinates and facilitates an accurate, organized and timely process for Medical Staff PPE including Peer Review.
Serves ad Medical staff liaison for PPE activities
Performs chart reviews as part of the PPE process
Participates in the development and reporting of data regarding PPE activities for the purpose of credentialing and for identification of trends and patterns.
Prepares materials required by the Medical Staff to conduct PPE
Meets Deadlines
Collaborates with all clinical team members during case review
Reports Concerns about clinical quality and patient safety, including related to behavioral issues, to appropriate leadership in a timely manner.
Maintains knowledge of, supports compliance with, and assists in preparation for surveys related to organizational, regulatory and certification requirements that apply to and guide Medical Staff PPE at all locations.
Develops and maintains collaborative relationships with Quality and Patient Safety, HIM/Medical Records Staff, Human Resources, Patient Care Management Staff, and others for the purpose of enhancing program effectiveness.
Participates in identifying and assisting in developing policies, procedures and processes in PPE functions.
Works independently and adapts to frequent changes in PPE and related processes
Effectively utilizes all computer systems needed to perform essential functions.
Simultaneously handles multiple electronic systems as needed.