RN, Coord, Quality Peer Review

MemorialCare • Long Beach, CA

1d • $58 - $84

About The Position

The RN Coordinator, Quality Peer Review, is responsible for managing and facilitating the medical staff's peer review process and supporting the delivery of high-quality care, patient safety, and continuous performance improvement. This position works closely with the medical staff and the peer review committee to ensure compliance with organizational policies, medical staff bylaws, and regulatory standards. Responsibilities include coordinating case reviews, providing accurate summaries, maintaining confidentiality, and supporting quality improvement initiatives. The coordinator will also provide accurate clinical summaries, data trends, reports, and analysis.

Requirements

• Minimum 2 years' acute hospital setting experience preferred.
• Proficient in computer skills including Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams, etc.,), RL Datix, and Electronic Medical Record such as EPIC preferred.
• Data Management proficiency and graphical display skills preferred.
• Experience in quality, safety, performance improvement and regulatory standards supported/required by external agencies [e.g. The Joint Commission, Centers for Medicare and Medicaid Services (CMS), California Department of Public Health (CDPH), and Agency for Healthcare Research and Quality (AHRQ)] preferred.
• Current Registered Nurse (RN) license in state of California required.
• Bachelor’s degree in nursing or higher preferred.

Nice To Haves

• Current certification/licensure of advanced, specialized study (such as CPHQ, CPPS, CPHFH, etc.), preferred.

Responsibilities

• Collaborates with physicians and other healthcare professionals at all levels, including Medical Staff leadership, Medical Staff Department, and Quality Assurance, to coordinate and facilitate the medical staff peer review process.
• Screens peer review referrals and key performance indicators and facilitates communication of cases for further medical staff review.
• Reviews, summarizes, and analyzes medical records to prepare case review summaries for physician review, with appropriate supporting and background documentation.
• Works with the medical staff coordinator to initiate measures that promote thorough physician review with an objective outcome.
• Attends multidisciplinary medical staff peer review committee meetings as cases are presented and reviewed.
• Enters outcomes of physician peer review into the appropriate software system.
• In collaboration with Quality Leadership and the Medical Staff Department, coordinates follow-up and action items from the peer review committee.
• Provides summary reports to medical staff committees, physician-specific reports for the credential committee, and physician profiles.
• Analyzes peer review referral and indicator data to identify trends, prepare reports, and make recommendations to the appropriate individuals and/or committees.
• Facilitates, leads, and actively participates in medical staff quality improvement efforts across departments and service lines.
• Identifies and communicates potential opportunities for improvement in non-physician clinical practice or hospital systems that affect cases under review to the appropriate hospital committee or leader and evaluates the response.
• Participates in the review of medical staff performance metrics, including mortality and patient safety indicators.
• Maintains knowledge of evidence-based practice, CMS, Joint Commission, and other regulatory agencies' standards and regulations pertaining to the medical staff peer review process and clinical metrics (e.g., eCQMs, AHRQ Patient Safety Indicators, Hospital-Acquired Conditions).
• Maintains knowledge of the hospital Medical Staff Bylaws, Rules and Regulations, and policies.
• Maintains confidential and privileged information in accordance with medical staff and hospital bylaws, state and federal laws, and regulations governing confidentiality and non-discoverability.
• Retains documents and records in a secure, confidential manner.
• Engages as an active team member in the Quality & Patient Safety department, sharing the common goal of improving the quality and safety of patient care.
• Attends and participates in departmental education/training in-services, team-building exercises, staff meetings, and other required departmental meetings.
• Participates in specific performance improvement projects.
• Performs other duties as assigned.

Benefits

• In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities.
• Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents.
• We offer high quality health insurance plan options, so you can select the best choice for your family.
• Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees