Saginaw, Michigan
Peer Review Specialist Job Opening in Saginaw, Michigan - DAY SHIFT
FULL TIME BENEFITED
Summary: The Peer Review Specialist will support the hospital?s medical staff peer review function in compliance with HFAP standards, CMS Conditions of Participation and the Medical Staff Bylaws. The Peer Review Specialist will oversee the day to day peer review process including acceptance of cases for peer review, facilitating first level screening if applicable, preparation of case review documents, documentation of peer review results, production of reports and maintenance of the peer review records. This person will remain current and insure compliance with peer review state statues, federal requirements, medical staff bylaws, internal policies and procedures, and HFAP regulations. They will be responsible for the education of the peer review process to hospital leadership, medical staff, and quality staff as appropriate. This position will support the medical staff and medical committees with a focus on peer review such as MSQI, service line committees and the organization through use of clinical expertise in review of concerns regarding quality of clinical care. The Peer Review Specialists collaborates with the medical staff leadership including The Medical Staff Quality Improvement Committee (MSQI), The Medical Executive Committee (MEC), and the Quality Steering Committee. This person will collaborate with members of the Risk Management, Patient Safety and Quality, Information Technologies, Clinical Resource Management and others as needed to obtain information related to performance of peer duties and responsibilities. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to Extraordinary Care for Every Generation.
Responsibilities:
Oversees the day to day peer review process from acceptance of cases for peer review, facilitating first level screening if applicable, preparation of case review documents, documentation of peer review results, production of reports and maintenance of the peer review records
Balances objectivity, confidentiality and transparency when communicating with medical staff and senior leadership
Ensures compliance to all standards and regulations involving medical staff peer review
Ensures compliance with the peer review process as outlined in the Medical Staff Bylaws and regulatory requirements
Secures all documents utilizing legal peer review protection
Proactively reviews professional sources for changes in the peer review process, regulatory changes, and legal
Maintains systems and processes of review (Paper, Electronic) per applicable regulations and laws for confidentiality and record maintenance
Develops a mechanism to distribute peer review findings and actions throughout the organization while preserving confidentiality
Cultivates a supportive and accountable warning / escalation system regarding peer review
Responds to external audits triggered by quality incidence or performance issues
Schedules and prepares for meetings as appropriate (Room reservations, agenda management, minutes, food, equipment, etc)
Collaborates with physician leadership regarding peer review for hospital level meetings ie: Medical Staff Quality Improvement (MSQI), Department Peer Review Meetings; Orthopaedic (Ortho), (Ob/Gyn), Pediatric (Peds), Trauma Transportable Physician Orders for Patient Preference/Peer Review (Trauma TPOPP/Peer Review) , Surgery, etc
Incorporates information from RL Solutions reports, adverse events, and other sources into the peer review process
Ensures confidentiality with patient and physician information, PHI, and demonstrates understanding of HIPAA
Answers the phones and responds to customer needs professionally
Participates willingly in department meetings to enhance team work and efficiency within the department
Willingly takes on additional assignments as needed within the department
Reports to work as scheduled, on time, sufficiently rested to perform the duties of the job
Takes initiative in keeping the Manager / Director fully informed on work related issues
As a member of the Patient Safety and Quality Department, this individual will commit to actively pursuing improvements in quality and patient safety metrics and support quality initiatives throughout Covenant HealthCare including continually looking for ways to improve the peer review process.
Other information:
REQUIREMENTS
Bachelor?s degree in health related field required
Registered Nurse (RN) with current MI license
3 - 5 Years of previous clinical experience
3 Years of previous quality improvement or patient safety experience preferred
Ability to define problems, collect data, establish facts, and draw valid conclusions
Ability to use word processing, spreadsheet, power point presentation, and third party vendor specific software (Midas, RL Solutions, etc)
Advanced knowledge of healthcare regulations, accreditation guidelines and standards related to the peer review process
Positive and highly effective interpersonal and written and verbal communication skills
Ability to work effectively with various levels of management personnel, physicians, board members, and other community members
Advanced skills in leadership and facilitation, decision-making, change management and conflict resolution
Excellent time management and organizational skills
Excellent analytical, critical thinking, and problem-solving skills
Ability to manage multiple priority projects simultaneously
Able to work flexible hours as needed
Able to work effectively and efficiently under tight deadlines, high volumes and multiple interruptions
Demonstrates ability to maintain information in a confidential manner
WORKING CONDITIONS/PHYSICAL DEMANDS
Frequently stand, walk, sit, talk and hear
Occasionally lift up to 50 pounds, carry, push, pull, climb, stoop, kneel and squat
NOTICE REGARDING LATEX SENSITIVITY IN APPLICANTS FOR EMPLOYMENT.
It has been determined that Covenant HealthCare cannot provide a latex safe or latex free work environment at any of its facilities. Unfortunately, that means that any individual, including an applicant or an employee, is likely to be exposed to latex while on Covenant?s premises. Therefore, latex tolerance is considered to be an essential function for any position with Covenant.
Job Type: Full-time
Required education:
Bachelor's
Required experience:
clinical: 3 years
Required license or certification:
Registered Nurse (RN)
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