Quality Review Specialist-RN

Lexington Medical Center • West Columbia, SC

3d • Onsite

About The Position

The Quality Review Specialist-RN provides consultative services regarding quality assessment and trends to medical staff and to hospital ancillary department personnel. In this role, the employee will perform comprehensive retrospective reviews in a timely manner utilizing criteria developed and approved by the medical staff, hospital, and regulatory agents.

Requirements

• High School Diploma or Equivalent
• 4 Years of clinical or hospital experience
• 2 Years of experience in quality or utilization review.
• Registered Nurse (RN)

Responsibilities

• Perform daily review of new occurrence reports.
• Identify occurrences that require additional follow-up and reports these to the Director or designee in a timely manner.
• Ensure that occurrences are categorized correctly and all fields completed and correct. Verifies data accuracy with medical record if necessary.
• Ensure that occurrence reports are forwarded to all appropriate persons.
• Access other sources of data as needed for investigation and follow up.
• Serves as System Administrator for the occurrence reporting system.
• Primary liaison between Risk Management, Information Services, and system users.
• Manages access to the occurrence reporting system.
• Adds new locations and new users and provides new-user training. Assigns passwords. Removes users as needed.
• Provides new user training and ongoing user support, paying keen attention to user needs and opportunities to offer solutions and modify processes to improve efficiencies.
• Coordinates with vendor and Information Services to troubleshoot system as needed.
• Assists with development, implementation, and evaluation of the hospital’s overall quality improvement program.
• Assist with coordination, preparation, and maintenance of performance improvement assessment and improvement activities.
• Responsible for data integrity and follows well defined processes for maintaining data integrity as well as manage assigned database.
• Assists in evaluation, analysis, maintenance and development of system functionality of the EHR to meet clinical objectives including participating in project plan development/tracking and workflow analysis.
• Provides accurate and timely routine statistical analyses and reports to designated parties. Identifies need for new reports and develops and creates reports. Generates user-friendly reports from other databases.
• Evaluates and analyzes data for trends, identifies areas of concern, and uses data display techniques to provide reports for various meetings and hospital committees.
• Prepares materials for meetings and assists with maintenance of performance improvement project records.
• Represents department on committees / teams as assigned.
• Participates and supports department goals, objectives and timelines, working with a sense of urgency and accuracy to ensure effective implementation. Successfully engages in multiple initiatives simultaneously and demonstrates flexibility in role and a willingness to help others.
• Attains an annual minimum of 12 hours of continuing education in topics related to role.
• May prepare materials for meetings and assists with maintenance of performance improvement project records.
• May represent department on committees / teams as assigned.
• Resolves problems and recommends solutions through research, inquiry, and data analysis, maintaining support call logs and tracking of issues.
• Compiles and maintains accurate statistics pertaining to occurrence data.
• Participates in and contributes to patient safety / risk reduction activities, including: Participates in and contributes to investigations of serious unanticipated events and "close-calls".
• Participates in and contributes to development, implementation and evaluation of corrective action plans.
• Supports a culture of safety by encouraging staff to speak up and report safety and quality issues.
• Identifies opportunities for improvement and coordinates/participates in the development and implementation of action plans to make improvements- recommends changes to systems/processes that do not contribute to desired outcomes.
• Works collaboratively and communicates effectively with administration, IS, and clinical care teams through participation in the planning, development, and evaluation and maintenance of the Clinical Information system.
• Audits database contents for accuracy and validity.
• Acts as a resource person in quality assessment activities with hospital departments and committees.
• Works directly with hospital personnel to provide assistance and guidance in establishing criteria, reviewing medical records, etc.
• Requires efficient use of numerous software products (Word, Excel, PowerPoint, Outlook, etc.)
• Performs all other duties as assigned.

Benefits

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
• Employer paid life insurance – equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• Employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Tuition reimbursement
• Student loan forgiveness

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED