RN, Coord, Quality Peer Review

Title: RN, Coord, Quality Peer Review

Location: Long Beach

Department: Quality Assurance

Status: Full-time

Shift: Day

Pay Range*: $57.81/hour - $83.81/hour

[Sign on Bonus Amount] signing bonus available to external hires new to MHS employment, contingent upon satisfaction of employment requirements.

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability.Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

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.

Essential Functions and Responsibilities of the Job

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. Performs other duties as assigned.

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. 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. And there's more...Check out ourMemorialCare Benefitsfor more information about our Benefits and Rewards.