Medical Staff Peer Review & Facility Enrollment Coordinator (FT, REMOTE)-Days

Position Summary

This position combines roles as Medical Staff Peer Review Coordinator and Facility Enrollment Specialist. The Medical Staff Peer Review Coordinator is responsible for coordinating and facilitating the peer review process to ensure quality, safety, and adherence to regulatory standards. The Facility Enrollment Specialist manages the enrollment processes for the hospital's facilities.

About the Role

The role includes coordinating and facilitating the medical and allied health staff peer review process, managing and coordinating the FPPE and OPPE processes, organizing review activities, maintaining documentation, and supporting medical staff in continuous quality improvement efforts. It also involves facilitating the evaluation of practitioner competence, supporting quality improvement initiatives, and maintaining accurate documentation of professional practice assessments.

Responsibilities

• Coordinate the peer review process for medical staff, including scheduling, communication, and documentation.
• Collect, organize, and maintain peer review data, reports, and related records in compliance with hospital policies and regulatory requirements.
• Aid medical staff and reviewers with the review process, ensuring timely and thorough assessments.
• Facilitate communication among medical staff, hospital administration, and review committees.
• Prepare summaries, reports, and follow-up documentation related to peer review activities.
• Analyze and compare initial privilege requests to clinical benchmark criteria.
• Oversee the implementation and ongoing administration of FPPE and OPPE programs.
• Cover the collection, review, and documentation of practitioner performance data.
• Ensure timely completion of FPPE when practitioners are initially credentialed or after renewal.
• Monitor and facilitate OPPE activities for ongoing performance evaluation.
• Gather data from various sources such as peer reviews, patient outcomes, incident reports, and other quality metrics.
• Prepare reports for medical staff leadership and hospital administration.
• Act as a liaison between medical staff, quality improvement, credentialing, and administrative departments.
• Educate physicians and providers on FPPE and OPPE processes and requirements.
• Facilitate communication regarding performance concerns and improvement plans.
• Ensure confidentiality and integrity of peer review information.
• Support compliance with accreditation standards and hospital policies regarding quality assurance and peer review.
• Assist in the development and implementation of policies and procedures related to peer review.
• Provide education and support to medical staff regarding peer review processes and expectations.
• Stay current with relevant regulations, standards, and best practices related to peer review and quality assurance.
• Ensure all FPPE and OPPE activities align with Joint Commission standards, state regulations, and hospital policies.
• Maintain documentation to support accreditation and licensing audits.
• Prepare and submit enrollment applications.
• Maintain accurate entity records.
• Track application statuses and resolve any issues that may arise during the enrollment process.
• Ensure compliance with all relevant regulations and payer requirements.
• Aid with periodic audits of provider files, ongoing compliance requirements for delegated credentialing.
• Administer and be the primary contact for payers and entities related to facility enrollment.

Requirements

• Required RN training + Physician Peer Review experience.
• Required educational degree in healthcare administration, nursing, or related field.
• Preferred certifications and licenses: Certified Peer Reviewer.
• Required experience: 5 years in acute hospital setting.
• PREFERRED experience: 2-3 years of Peer Review, Quality, Patient Safety and Facility Enrollment.

Qualifications

• Knowledge of medical staff processes, healthcare quality assurance, and regulatory standards.
• Strong organizational and communication skills.
• Ability to handle sensitive information with discretion.
• Experience with healthcare documentation and data management systems.
• Experience in medical staff services, credentialing, or quality improvement.
• Knowledge of accreditation standards (e.g., The Joint Commission), regulatory requirements, and healthcare quality metrics.
• Strong organizational, analytical, and communication skills.
• Attention to detail and ability to manage multiple priorities.
• Familiarity with healthcare data management systems and credentialing software.
• Excellent interpersonal and collaboration skills.
• Ability to interpret and apply complex regulatory standards.
• Discretion and confidentiality in handling sensitive information.

Skills

• Knowledge of medical staff processes, healthcare quality assurance, and regulatory standards.
• Strong organizational and communication skills.
• Ability to handle sensitive information with discretion.
• Experience with healthcare documentation and data management systems.
• Experience in medical staff services, credentialing, or quality improvement.
• Knowledge of accreditation standards (e.g., The Joint Commission), regulatory requirements, and healthcare quality metrics.
• Strong organizational, analytical, and communication skills.
• Attention to detail and ability to manage multiple priorities.
• Familiarity with healthcare data management systems and credentialing software.
• Excellent interpersonal and collaboration skills.
• Ability to interpret and apply complex regulatory standards.
• Discretion and confidentiality in handling sensitive information.

Benefits

N/A

Pay

N/A

Schedule

N/A