RN , Quality Peer Review Specialist

Trinity Health • Columbus, OH

9d • Onsite

About The Position

The Peer Review Specialist provides leadership and coordination for the provider peer review processes across the facilities and service areas within Mount Carmel Health System and affiliate joint venture businesses as assigned.

Responsibilities Exhibits each of the Mount Carmel Service Excellence Behavior Standards holding self and others accountable and role modeling excellence for all to see. For example: demonstrates friendliness and courtesy, effective communication creates a professional environment and provides first class service.Meets population specific and all other competencies according to department requirements. Promotes a Culture of Safety by adhering to policy, procedures and plans that are in place to prevent workplace injury, violence or adverse outcome to associates and patients. Relationship-based Care: Creates a caring and healing environment that keeps the patient and family at the center of care throughout their experience at Mount Carmel following the principles of our interdisciplinary care delivery system. (For patient care providers) Provides nursing care, ensures an environment of patient safety, promotes evidence-based practice and quality initiatives, and exhibits professionalism in nursing practice within the model of the ANCC Magnet Recognition Program®.
Steward human and financial resources in a responsible manner.

Requirements

• Baccalaureate Degree in Nursing required.
• Current license to practice as Registered Nurse in the State of Ohio.
• Minimum of five (5) years recent hospital practice.
• Effective Communication Skills
• Current knowledge of regulatory and accrediting requirements
• Proficient computer skills
• Able to prepare and present executive level summaries and presentations

Nice To Haves

• Masters in Nursing preferred.
• Clinical and management experience preferred.

Responsibilities

• Facilitates the provider peer review process including case identification through internal reporting data, registries, or the incident reporting system based on defined indicator criteria.
• Writes case summaries for cases that meet the peer review indicator list and sends them to physician reviewers for further evaluation.
• Leads provider peer review committee meetings in partnership with the committee chair ensuring timely and effective case discussion and resolution.
• Onboards new peer review committee members and department chairs, providing education on peer review responsibilities and Ongoing Professional Practice Evaluation (OPPE) requirements.
• Tracks and analyzes peer review trends, escalating system-level concerns as appropriate.
• Drafts provider communications based on peer review needs.
• Maintains provider files with all peer review-related documentation and communications.
• Partners with the legal team to ensure peer review processes and documentation meet compliance and risk standards.
• Prepares and presents executive-level summaries and reports related to peer review findings and provider performance.
• Reviews peer review committee charters and policies and facilitates updates with approval from the Medical Executive Committee when needed.
• Maintains current knowledge of regulatory and accrediting requirements relevant to peer review and OPPE.
• Collaborates with department chairs to complete OPPE documentation in alignment with regulatory standards and internal policies.
• Attends Joint Commission or other regulatory meetings related to medical staff review of OPPE.
• Maintains confidentiality of all peer review and OPPE-related communications, documentation, or processes in accordance with regulatory and organizational standards.
• Audits peer review and OPPE processes to ensure adherence to established protocols while identifying potential gaps.
• Communicates identified system-level issues arising during the peer review process to the appropriate team for follow-up and resolution.
• Travel to various sites as required.

Benefits

• Competitive compensation and benefits packages including medical, dental, and vision coverage
• Retirement savings account with employer match starting on day one
• Generous paid time off programs
• Employee recognition incentive program
• Tuition/professional development reimbursement
• Relocation assistance (geographic restrictions apply)
• Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing
• DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level