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Peer Review Quality Specialist, .8 FTE Exempt, IN-DEPT APPLICANTS ONLY

at TheLabRat

Posted: 8/2/2016
Job Status: Full Time
Job Reference #: 689164

Job Description

Job Description

Job Title:

Peer Review Quality Specialist, .8 FTE Exempt, IN-DEPT APPLICANTS ONLY

Company Name:

St. Peter's Hospital

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Employment Type:

Full Time (Exempt)


HELENA, MT, United States


Organizational Excellence


Highly Competitive

Shift Hours/ Days:

Monday - Friday business hours

Hours/Pay Period:

Degree Required:

None Specified

Job ID:

Date Posted:

Jul 29, 2016

Years Experience:


Note: Please read the complete description below before applying for this job.

Complete Description

JOB SUMMARY (overview of job): The Peer Review Quality Specialist works closely with the VPMA to develop processes for ongoing and focused professional practice evaluations and independent review as part of the peer review process, including collection and analysis of quality indicators and event reporting for aggregate and individual physician groups. Identifies trends as well as quality improvement opportunities. Works with the various physician departments and presents /explains findings. Provides leadership and coordination of the medical staff peer review process. Works independently to ensure all established inclusion criteria are reviewed against regulatory standards, such as TJC and CMS. This position requires coordination of confidential communication and critical thinking skills as it pertains to various, selected quality indicator reviews within a medical record for the hospital's medical staff departments.

Main duties and functions:

Coordinates and facilitates physician peer review process, to include ongoing and focused professional practice evaluations

Monthly inpatient and outpatient Peer, FPPE and OPPE preparation for physician review

Biannual OPPE data compilation

Quarterly provisional year preparation for physician review, including routing and tracking of provisional charts

Extensive chart review and preparation for external review

Development of dashboards to accurately reflect Peer and OPPE review efforts for hospital and clinic providers

Provides complete and final OPPE, FPPE and Peer data to Medical Staff Services for provider reappointments and provisional advancement

Completes monthly case rating forms

Notifies providers as needed regarding reviews, issues identified or commendations

Diligently vets data to ensure accuracy

Supports quality assurance efforts for the Medical Staff Committees, including as needed researching potential aggregated quality assurance metrics and developing methods to track and trend for identification of improvement opportunities

Assists growth of outpatient peer review process

Attends and provides support for Peer Review Committee meetings, may include agenda development and minutes

Supports regulatory readiness for The Joint Commission and CMS requirements

Maintains knowledge of relevant St. Peter’s Hospital policies

Facilitates completion, resolution and tracking of event and complaints pertaining to provider behavior and/or practice

Ongoing communication with the VPMA regarding provider peer review

Active membership on relevant hospital committees, including Peer Review, Patient Safety, may include agenda development and minutes

Conducts orientation for newly appointed department chairs

Participates in new provider orientation to communicate hospital expectations for Peer, FPPE, OPPE and Provisional Year

Reviews non-core privilege requests for peer review purposes

Provides ongoing departmental back up for the complaint line, responding to patient complaints, event reporting, RCAs and other operational needs

Other duties as assigned

KNOWLEDGE/EXPERIENCE: Registered Nurse with a minimum of 3-5 yrs of clinical experience. Training or experience in review of medical records, hospital processes, and peer review processes preferred. Knowledge, competency and experience in OPPE, Peer review and provisional monitoring for inpatient and outpatient services. Outstanding verbal and written communication skills are required.

EDUCATION: Graduate of professional school of nursing

LICENSE/CERTIFICATION/REGISTRY: Licensed registered nurse (RN) in Montana. Should not have any restrictions on license that would inhibit completion of assigned duties such as restrictions on handling or dispensing of controlled substances.


*Demonstrated ability to obtain results in key areas such as clinical quality and service excellence.

*Demonstrated ability to create an environment of mutual trust and respect and two-way communication with all disciplines.

*Demonstrated ability to build team spirit and excitement.

*Demonstrated ability to actively pursue positive change, both personally and organizationally. Demonstrated ability to adapt to change.

*Demonstrated ability to work in interdisciplinary team for the benefit of the organization as a whole.

*Demonstrates integrity by actions that are consistent with what she/he says, communicating ideas openly and directly, and welcoming openness and honesty.

*Demonstrated ability and commitment to foster the growth and development of others. This includes the ability to be direct and clear; providing tools and assistance, while ensuring organizational leaders develop performance improvement skills to ensure organizational spread.

*Demonstrated ability to effectively direct the activities of individuals and groups towards the accomplishment of established goals.

*Demonstrated ability to manage multiple and conflicting priorities, stressors, deadlines, difficult situations and/or customers effectively.