Central Health

  • RN Peer Review Coordinator

    Req No.
    2018-3208
    Company
    CommUnityCare Health Centers
    Name
    North Central
    Address
    1210 Braker Lane
    City
    Austin
    Category
    Professional
    State
    TX
    Type
    Regular Full-Time
    Shift Days
    Monday through Friday
    Shift Hours
    8-5
  • Overview

    The Nurse Paralegal responsibilities are all related to assessing and improving the quality of medical services and/or care at CommUnityCare. This includes coordination with the Peer Review Committee to oversee the ongoing peer review program, quality planning, assurance and improvement.  The Nurse Paralegal works under the supervision of the Peer Review Committee Chair and Chief Legal Officer.

    Responsibilities

    Essential Duties:

    • Review and analyze medical documentation and records to establish quality of care.
    • Outline and compose narrative summaries, chronologies of medical records, correspondence and reports.
    • Compose and type document procedures, including case analysis memoranda for legal.
    • Work closely with the Peer Review Committee Chair and organizational leadership regarding statues and regulations pertaining to peer reviews.
    • Assist in responses to patient complaints and discovery requests.
    • Assist with the creation and analysis of Ongoing Provider Performance Evaluation (OPPE) and Focus Provider Performance Evaluations (FPPE).
    • Keeps up to date on medical quality of care in order to identify substandard care.
    • Assist in development and implementation of program plans.
    • Design, maintain and manage quality related databases and develop trending and other statistical reports.
    • Assist in the identification, development, implementation and reporting on disease management programs.
    • Assist organizational leadership with medical evidence preparation and organization for committees, hearing and trials.
    • Perform other duties as assigned

    Knowledge/Skills/Abilities:

    • Proficient understanding and utilization of medical technology, anatomical drawing, laboratory technology and medication.
    • Thorough understanding of medical conditions to explain a diagnosis.
    • Knowledgeable with HIPPA compliance, regulations and all other state & local required regulatory mandates.
    • High degree of initiative and the ability to plan, prioritize and manage multiple tasks; ability to work with minimal supervision.
    • Requires research, analytical, organizational and critical thinking skills.
    • Excellent verbal and written communication skills.
    • Exercise good judgment and maintain confidentiality in maintaining critical and sensitive information, records, and reports.
    • Strong attention to detail and accuracy.
    • Highly proficient in Microsoft Office Suite programs i.e. Word, Excel, PowerPoint and Outlook and medical software.
    • Experience in database design, maintenance and reporting.
    • Ability to work in a team environment; flexibility with work schedule.
    • Ensure all tasks and duties comply with all regulatory and accreditation standards including The Joint Commission and CommUnityCare Standard Operating Procedures and CommUnityCare Policies and Procedures

    Qualifications

    MINIMUM EDUCATION:  Graduation from an accredited School of Nursing.

     

    PREFERRED EDUCATION:  Bachelors of Science in Nursing.

     

    MINIMUM EXPERIENCE:   6 – 8 years as a registered Nurse in areas such as managed care, quality assurance/improvement, medical/surgical settings and/or case or disease management. Prior experience as a Paralegal.

     

    REQUIRED CERTIFICATIONS/LICENSURE:   

    • Current, relevant state licensure to practice nursing in the State of Texas.
    • Current Health Care Provider Cardiopulmonary Resuscitation (CPR) certification through American Heart Association or American Red Cross. Will be required to maintain a current CPR certification during employment.

     

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