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- St. Augustine, Florida
- Nursing
- 54357
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Overview
Job Description
The Peer Review Coordinator will support the hospital's medical staff peer review function in compliance with legal and regulatory standards, CMS Conditions of Participation and the Medical Staff Bylaws. The Peer Review Coordinator 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 Joint Commission 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 and the facilitation of PPC, as well as service line committees and the organization through use of clinical expertise in review of concerns regarding quality of clinical care. The Peer Review Coordinator collaborates with the medical staff leadership, The Medical Executive Committee (MEC), and the Medical Staff office. This position will support the OPPE and FPPE process for the hospital to ensure the quality of care provided and compliance with regulatory standards. This person will collaborate with members of the Risk Management, Patient Safety and Quality, Information Technologies, 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 Flagler Health+ Mission, Vision and Values.
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.
- Ensures compliance to all standards and regulations involving medical staff peer review. Also, ensures compliance with the peer review process as outlined in the Medical Staff Bylaws and regulatory requirements. Proactively reviews professional sources for changes in the peer review process, regulatory changes, and legal. Responds to external audits triggered by quality incidence or performance issues.
- Secures all documents utilizing legal peer review protection. 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.
- 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.
- 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.
Qualifications
Required education:
- Associates degree in Nursing
Required Experience
- 3 years nursing experience
Preferred Experience
- 3 years of previous quality improvement or patient safety experience in a nursing role.
License Requirement
- Active FL Nursing License
Additional Information
- ACS NSQIP Participation.
- Successfully completes the ACS NSQIP SCR Training/Certification program.
- Participates in program teleconferences.
- Attends ACS NSQIP National Conference.
Skills And Abilities
- 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 (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.
