Job Summary

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.

Job Duties

• 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.

Position Details

Hours: 40 hours per week; 8:00a-4:30p

Weekends, Holidays and On-Call: None

Travel: less than 25%- some travel to GBH/GSACH

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Geisinger cares about not only its patients and members, but also about you and your family. We offer a competitive compensation and benefits package to ensure that you and your loved ones can maintain good health, achieve financial stability, and excel both personally and professionally. We believe in creating a diverse and inclusive environment where all employees can be their authentic selves. To learn more: https://jobs.geisinger.org/diversity

• Full benefits (health, dental and vision) starting on day one
• Three medical plan choices, including an expanded network for out-of-area employees and dependents
• Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA)
• Company-paid life insurance, short-term disability, and long-term disability coverage
• 401(k) plan that includes automatic Geisinger contributions
• Generous paid time off (PTO) plan that allows you to accrue time quickly
• Up to $5,000 in tuition reimbursement per calendar year
• MyHealth Rewards wellness program to improve your health while earning a financial incentive
• Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones
• Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.
• Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance

Education

Bachelor's Degree-Nursing (Required)

Experience

Minimum of 2 years-Managing people, processes, or projects (Required)

Certification(s) and License(s)

Basic Life Support Certification - Default Issuing Body; Valid Driver's License - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania

Skills

Clinical Skills; Critical Thinking; Computer Literacy; Working Independently; Teamwork; Communication; Organizing

About Geisinger

Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.

Our Commitment to Diversity, Equity and Inclusion

Geisinger values who you are, where you are from, and where you are going. We seek out people of various backgrounds and cultures with unique abilities, non-traditional career paths and ambitious aspirations. 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. Read more about Our Commitment to Inclusive Recruiting.

Our Vision & Values

Everything we do is about making better health easier 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.

Our Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.