Clinical Reviewer

Primary Location Burnet Campus Department Surgical Services Shift Day (United States of America) Schedule Full time Weekly Hours 40 FTE 1 Employee Status Regular *Expected Starting Pay Range $76,336.00 - $97,489.60 *Starting pay is based on experience, skills, and equity; exceptions may apply for highly qualified candidates. Additional pay (e.g., shift, on-call, or weekend differentials) and benefits may apply. Annual pay may vary based on FTE status.

JOB RESPONSIBILITIES

Data Coordination - Direct and coordinate all aspects of data collection, data harvest, quarterly outcomes report analysis and review. Responsible for monthly statistical and analysis reporting of department data. Track and trend information. Responsible for the production of routine quality monitoring reports and activities at the hospital. Quality Improvement - Supervise and coordinate quality improvement efforts, either within the department or within a larger quality assessment team, related to data collection and reporting. Apply data to facilitate quality improvement activities and provide national comparative clinical benchmarks. Participate in improving organizational performance through recommending areas or approaches for improvement activities, performing new procedures, collecting data, and providing input to department discussions. Identify gaps or compliance issues. Continuously improve care. Review, analyze, and summarize recommendations regarding utilization, quality and severity measurements. Support quality improvement initiatives by providing data to physicians, clinicians and other special project participants. Information Analysis - Utilize software applications, both internal and external, for data collection and analysis. Responsible for the accurate and timely entry of data into the program's database and ensures compliance with national registry requirement and protocols. Monitor and assure timeliness, accuracy, availability and security of information. Assist with, participate in, and support research initiatives. Analyze and evaluate data and clinical information to identify quality issues and trends. Systematically and accurately collect and compare statistical data from hospital departments, reports and patient medical records. Analyze and make recommendations. Prepare reports to present data in a meaningful manner. Collect appropriate quality performance data and clinical information. Compile data and reports to appropriate hospital committees. Collaboration - Establish effective working relationships with members of the hospital community, especially departments whose support is necessary for the management and success of the program. Collaborate with interdisciplinary team to define outcome parameters, design measurement tools, and evaluate results. Build relationships and gain alignment for clinical support among all divisions. May serve as an educational resource for internal and external audiences by developing educational material and delivering presentations. Functions as a resource in formulating action plans and communications related to findings. Professional Inquiry - Consult and collaborate with others. Maintain currency in field through continuing education, literature and seminars. Represent the department and Cincinnati Children's at local, state, and national levels through involvement in professional associations and organizations. Implement the knowledge into the department. May assist with and participate in research initiatives. Clinical Review - Review patient's records, conduct interviews with hospital employees and or medical staff members when concerns about appropriateness of care or professional conduct are raised. Communicate with physicians when alternatives to care are indicated by clinical review. Monitors cases for appropriateness of continued stay, level of care and services and quality of care using approved screening criteria. Refers cases as needed for second level of review. Defuses sensitive situations when working with healthcare professionals. May follow up to conduct or develop corrective and/or preventable practices and procedures. Compliance - Reviews patient medical records for treatment appropriateness, protocol compliance and other review activities including monitoring related to core measures. Insures and facilitates compliance with protocols and documentation requirements. Conducts retrospective medical record reviews and abstraction for quality and utilization review case. JOB QUALIFICATIONS Bachelor's degree or equivalent combination of education and experience May require clinical license, certification or training 5+ years of work experience in a related job discipline About Us At Cincinnati Children's, we come to work with one goal: to make children's health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children's. Cincinnati Children's is: Recognized by U.S. News & World Report as a top 10 best Children's Hospitals in the nation for more than 15 years Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding Recognized as one of America's Best Large Employers (2025) , America's Best Employers for New Grads (2025) One of the nation's America's Most Innovative Companies as noted by Fortune Consistently certified as great place to work A Leading Disability Employer as noted by the National Organization on Disability Magnet® designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC) We Embrace Innovation-Together. We believe in empowering our teams with the tools that help us work smarter and care better. That's why we support the responsible use of artificial intelligence. By encouraging innovation, we're creating space for new ideas, better outcomes, and a stronger future-for all of us. Comprehensive job description provided upon request. Cincinnati Children's is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability Cincinnati Children's