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DATE ADDED: Wed 02/10/2019

QI /Physician Peer Review/ RN

Tacoma, WA, US
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COMPANY: CQUENSYS

JOB TYPE: Permanent, FullTime

GENERAL DESCRIPTION

The RN works under the supervision of the Medical Staff Services Director. This position works with medical/clinical leadership and other health care teams in planning, implementation, maintenance, and continuing evaluation of clinical quality improvement, event reporting, and the physician peer review process. The RN performs timely clinical reviews; directs cases for physician peer review; refers and tracks event reports, and provides data analysis. The RN assists with performance improvement activities and supports the clinical activities of the peer-review process. The RN assesses trended data and identifies possible opportunities to improve patient outcomes through collaboration with Quality, Risk, Nursing, Medical, and Ancillary Departments. The RN works with medical/clinical leadership to identify methodologies to improve clinical effectiveness, patient safety and other quality performance areas as appropriate.

Work situations require a professional, service-oriented individual, strong organization skills, accuracy, speed, good judgment and independent thinking within the scope of the position's responsibility. Internal contacts include clinical/medical staff and management throughout the Hospital. External contacts include physicians and their office staff and regulatory agencies.

PRINCIPAL ACCOUNTABILITIES

  • Coordinates reviews on inpatient medical records throughout the organization in support of internal/external case reviews.
  • Ensures that data entered into the database is complete and prepares timely, accurate reports for internal use.
  • Gathers and analyzes data from various data sources to identify issues/trends.
  • Refers to systems issues, QI and Risk topics to appropriate leaders.
  • Refers events to appropriate leadership and monitors for response and/or direction.
  • Reviews and refers to the quality of care events/concerns to appropriate Peer Review Committees.
  • Oversees database and reporting system for data analysis and improvement.
  • Ensures timely entry of data obtained during reviews.
  • Analyses data and prepares reports for leaders as requested.
  • Manages data validation and, when required, validation appeal process to assure compliance required to maintain optimal data integrity and market-based allocation.
  • Conducts thorough research, interviews, retrospective chart reviews on all variances forwarded through quality software regarding patient/family complaints and/or questions concerning the provision of care by medical staff providers.
  • Analyses data and utilizes performance improvement tools and techniques, such as graphs, run charts, control charts in performance improvement reports to Medical Staff Departments and Administration.
  • Maintains Clinical Documentation knowledge.
  • Actively updating with clinical medical education related to the area of expertise utilizing external agency and other resources as appropriate.
  • Remains abreast of advances and current trends in clinical documentation and regulatory requirements
  • Assists in the improvement of processes relating to clinical effectiveness, patient safety and other quality performance areas as appropriate.
  • Adheres to Hospital Attendance and Punctuality Policy and Procedure standards, and maintains reliable attendance Contributes to the success of the organization by meeting organizational competency expectations and core values (respect, integrity, stewardship, excellence, collaboration and kindness), continuously learning, and by performing other duties as needed or assigned.

VALUES BASED BEHAVIORS

  • Respect: Seek first to understand
  • Integrity: Do the right thing
  • Stewardship: Live lean
  • Excellence: Be your best/Act for safety s sake
  • Collaboration: Team up
  • Kindness: Create warmth and comfort

MINIMUM QUALIFICATIONS

KNOWLEDGE, SKILLS, & ABILITIES

  • Knowledge of clinical documentation requirements.
  • Knowledge of regulatory requirements relating to clinical documentation.
  • Knowledge of medical terminology.
  • Skill in providing excellent customer service.
  • Skill in time management.
  • Ability to produce reports and statistical analysis
  • Ability to conduct clinical literature research
  • Ability to work efficiently under pressure.
  • Ability to attend to detail and perform accurate work.
  • Ability to communicate in writing and verbally in the English language in an effective manner, to include accurate spelling and legible writing.
  • Ability to listen actively and respond to fellow employees/customers in a timely, competent manner both verbally and non-verbally.
  • Ability to work independently, set priorities and take initiative.
  • Ability to willingly accept responsibility
  • Ability to set priorities and use good judgment.

EDUCATION & EXPERIENCE

  • Bachelor of Science Degree in Nursing
  • Three (3) years of peer review experience
  • Three (3) years of recent clinical experience
  • One (1) year of quality assessment and improvement experience
  • Licensed as a Registered Nurse in the State of Washington
  • Previous experience with computerized information systems (email, MS Office, hospital systems, etc)
- provided by Dice
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