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Job SummaryEvaluates 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 DetailsHours: 40 hours per week; 8:00a-4:30pWeekends, Holidays and On-Call: NoneTravel: less than 25%- some travel to GBH/GSACH 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
EducationBachelor's Degree-Nursing (Required)ExperienceMinimum of 2 years-Managing people, processes, or projects (Required)Certification(s) and License(s)Licensed Registered Nurse (Pennsylvania) - RNState of Pennsylvania; Valid Driver's License - Default Issuing Body; Basic Life Support Certification - Default Issuing BodyOUR 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.
