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Peer Review Specialist

Quality Management

Per Diem

Day - 8 hours

11333

Bachelors Degree preferred
Valid CA RN license

St. Francis Medical Center (SFMC) is dedicated to serving the healthcare needs of the communities of Southeast Los Angeles. Our vision is to be a values-driven integrated health care delivery system in collaboration with those who share our values. We operate a 384-bed acute care hospital and one of the largest and busiest private emergency trauma centers in Los Angeles County -- treating more than 84,000 children and adults each year. Last year, more than 5,000 babies were born at SFMC's Family Life Center, with 875 babies cared for in our state-of-the-art Neonatal Intensive Care Center. We are a Primary Stroke Care Center and STEMI Receiving Center, both of which are approved by the Los Angeles County Emergency Medical Services Agency.

Position Summary

Under the direction of the Director of Medical Staff Services, coordinates an effective medical staff peer review process that supports medical staff reappointment, advancement, and clinical quality in compliance with Joint Commission ongoing physician performance evaluation (OPPE), focused professional practice evaluation (FPPE) standards.  Performs review of medical records as identified by pre-approved clinical indicators based on established definitions for peer review for assigned populations and provides timely feedback to clinical management and physicians to ensure optimal quality patient care. Serve as a clinical resource to the peer review coordinators.

 

This position requires the full understanding and active participation in fulfilling the Mission of St. Francis Medical Center. It is expected that the associate holding this position will demonstrate behaviors consistent with our core values and will comply with all required standards governing our commitment to Compassionate Care, Exemplary Service and serving our patients. The associate holding this position will support St. Francis Medical Center's strategic and annual operating plan and all essential elements of Quality Improvement and Financial Stewardship.

 

Position Description

  • Responsible for coordinating effective physician peer review to assess the quality of medical care by performing a critical review, utilizing skills and knowledge of clinical care guidelines and national priorities for care.
  • Performs an objective medical record review of each case identified regarding appropriateness of patient care based on evidence-based outcomes and clinical guidelines working with the department chairman, Director of Medical Staff Services and Physician Peer Review Committee to identify opportunities to improve and/or educational/training needs.
  • Assists Department and Committee Chairperson or designated physician peer reviewer in case review performance and documentation.
  • Responsible for facilitating current physician performance evaluation activities in accordance with Joint Commission requirements including preparation of case summaries and accurate timely documentation for every case review for each medical staff department and committee involved in monitoring/improving quality and appropriateness of care.
  • Utilizes superior discretion and ability to maintain confidential, sensitive physician peer review information. Use appropriate safeguards to prevent inappropriate use or disclosure of confidential case review information.
  • Reports all opportunities identified to improve processes policy/procedures.
  • Coordinates and/or attends department and committee meetings. Prepares with preparation of agenda and materials for presentation. Records minutes at specified committee meetings.
  • Works collaboratively with a wide range of healthcare professionals including providers other healthcare leaders and medical records personnel.
  • Performs additional duties and responsibilities as requested.

 

Education/Training/Experience

Minimum 2 years clinical experience in an acute-care setting required, plus 1 year experience in Quality or Risk Management work or an equivalent combination of education, training and experience.

Excellent oral, written and interpersonal skills.

Strong organizational, analytical and problem solving skills.

Proficiency with Microsoft Office Products (Word, Excel, PowerPoint)

 

Licenses/Certifications

Valid CA RN License required

 

Physical Demand Analysis

Must continuously (66% to 100% of a work day):

Sitting
Must frequently (34% to 66% of a work day):

Wrist Rotation and deviation

Twisting of neck

Typing

Must occasionally (11% to 33% of a work day):

Lift maximum of 5 lbs.

Standing

Reaching

Walking