QUALITY REVIEW RN - HOAG CLINIC CLINICAL SERVICES

Hoag Memorial Hospital Presbyterian • Full-time • Costa Mesa, CA, US • 1w ago

Salary Range: $47.7200 - $73.3700 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education.

Primary Duties and Responsibilities

Under the direction of the Director Clinical Services for Hoag Clinic, develops and coordinates an effective and continuously improving healthcare practitioner peer review program. Coordinates and oversees the process of performing objective medical record review of each case for appropriateness of care based on evidence-based clinical care guidelines, in collaboration with the Division Chiefs. Coordinates and leads regular peer review body meetings. Ensures follow-up actions on each case are implemented, e.g., education/ training, monitoring/ proctoring, change in privileges, behavior counseling, or summary suspension/ termination. Ensures peer review activities are timely and meet all internal requirements and are compliant with external standards and regulations, state laws and Medicare Conditions of Participation. Maintains complete and accurate records of peer review activities. Develops and oversees operational quality indicators. Assists the Director Clinical Services in preparation of reports and presentations. Utilizes superior discretion and appropriate safeguards to maintain confidentiality and prevent inappropriate use or disclosure of sensitive information. Performs other duties as assigned.

Education and Experience

Required:

Associate’s degree in nursing or another healthcare field
At least five (5) years clinical experience
At least one (1) year experience in quality and/or risk management work
Highly proficient with Microsoft Office suite of products, including Word, Excel, Outlook, and PowerPoint
Experienced user of Electronic Health Records (EHR)
Comprehensive knowledge of medical terminology

Preferred:

Bachelor’s degree in nursing or another healthcare related field
Experience with EPIC
Experience in database management

License Required

Current licensure as a Registered Nurse in good standing in the State of California

Certifications Preferred

Certified Professional in Healthcare Quality (CPHQ) or Certified Professional Medical Services Management (CPMSM)

About Hoag

Hoag is a nonprofit, regional healthcare delivery system in Orange County, California. Delivering world-class, comprehensive, personalized care, Hoag consists of 1,800 top physicians, 15 urgent care facilities, 10 health and wellness centers, and two award-winning hospitals. Hoag offers a comprehensive blend of health care services that includes seven institutes providing specialized services in the following areas: cancer, digestive health, heart and vascular, neurosciences, spine, women's health, and orthopedics through Hoag's affiliate, Hoag Orthopedic Institute, which consists of an orthopedic hospital and four ambulatory surgical centers. Hoag is the highest-ranked hospital in Orange County by U.S. News & World Report and the only OC hospital ranked in the Top 10 in California, as well as a designated Magnet® hospital by the American Nurses Credentialing Center (ANCC). For more information about Hoag careers, visit careers.hoag.org.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.

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