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.
Hours: 8:00 AM to 4:30 PM
Travel: Limited for coverage and meetings
On call: Yes, will be reviewed at an interview
Required experience: BSN with 2 years of RN work experience and 2 years of managing people, processes or projects
At Geisinger, the caring that we provide to our patients and members also extends to you and your family. Our competitive compensation and benefits package helps you and your loved ones stay healthy, meet your financial goals and thrive professionally and personally.
Benefits: Geisinger offers a comprehensive suite of healthcare benefits, including medical, prescription drug, vision, dental coverage and 401K. And with our healthcare benefits, you'll also receive care from one of the top innovative healthcare systems in the country. Our suite of benefits supports you and your family in a variety of ways, including coverage for same-sex or opposite-sex spouses, domestic partners and their children and stepchildren.
Paid Time Off: Our generous paid-time-off packages allow you to take the time you need to travel, rest, and care for and reconnect with friends and family. We also offer paid military and parental leave.
Diversity and Inclusion: We strive to create an environment where our patients, health plan members and employees can be their most authentic selves. Join one of our many Employee Resource Groups (ERGs). ERGs provide opportunities for all Geisinger employees to build internal and external networks and further develop professionally. ERGs are formed around common identities but are open to all employees.
Tuition Assistance: Up to $5,000 tuition reimbursement: We offer tuition reimbursement towards both undergraduate and graduate degrees.(Part time and Full Time Positions only)
Retirement: We contribute 5% of your salary to your retirement plan and offer auto-enrollment to make saving convenient for you.
Bachelor's Degree-Nursing (Required)
Minimum of 2 years-Managing people, processes, or projects (Required), Minimum of 2 years-Nursing (Required)
Certification(s) and License(s)
Valid Driver's License - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania; Basic Life Support Certification - Default Issuing Body
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
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 FoodFarmacy, 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 sequencingprograms, 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 1...3 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.