Evaluates the quality of health care rendered by the System for the purpose of Peer Review pursuant of the Medicare Act, as directed by, and as a member of the System's Performance Improvement Department, a Peer Review Subcommittee of Geisinger, by evaluating the quality of services ordered or performed by the System's professional healthcare providers including practice analysis, inpatient hospital utilization reviews, medical audits, and the compliance of assigned department, with the standards set by associations of healthcare providers and with applicable laws, rules and regulations. Responsible for coordinating and supporting Performance Improvement activities and identifying ongoing data and information system needs as part of the System's Peer Review process.
Demonstrates a comprehensive understanding of the theory and principles of clinical performance improvement. Creates and fosters change in a positive proactive manner. Fosters problem-solving using critical thinking skills. Coordinates and participates in the development and implementation of Peer Review programs and activities in the assigned areas and departments. Reviews and monitors occurrences, quality triggers and quality of care concerns observing for problems or patterns affecting the quality of care for appropriate Peer Review protected action as assigned. Educates and orients providers, administration, professional and line staff as needed regarding Performance Improvement requirements and methodologies in a Peer Review protected forum. Serves as resource person for Performance Improvement initiatives within the Division of Pediatrics. Assists with and provides direction to staff in developing measurements for Performance Improvement and evaluation activities. Develops data collection tools, data collection, summarization of data and reporting of findings in a Peer Review protected process. Schedules and assists with follow-up studies to determine effectiveness of corrective action in a Peer Review protected process. Prepares and submits monthly Performance Improvement Reports within the System's Peer Review Committee structure as assigned. Maintains appropriate records of all Performance Improvement activities. Assists in the preparation and coordination of all regulatory surveys. Actively participates in all surveys. Conducts and coordinates the follow-up of survey recommendations and requirements. Educates employees on changes in regulatory standards. Facilitates, coordinates, and participates in multidisciplinary Peer Review protected Performance Improvement workgroups and projects, as assigned. Reports potentially compensable events to the risk manager in a Peer Review protected process. Coordinates and conducts Peer Review protected chart reviews for Medical Records and Procedure Committee within established time frames. Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.
Bachelor's Degree-Nursing (Required)
Minimum of 2 years-Managing people, processes, or projects (Required)
Certification(s) and License(s)
Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Valid Driver's License - Default Issuing Body; Basic Life Support Certification - American Heart Association (AHA)
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.