Quality Review Specialist-RN

Quality Management - Acute Full Time Day Shift

Quality Review Specialist-RN provides consultative services regarding quality assessment and trends to medical staff and to hospital ancillary department personnel. In this role, the employee will perform comprehensive retrospective reviews in a timely manner utilizing criteria developed and approved by the medical staff, hospital, and regulatory agents.

Minimum Qualifications:

• Minimum Education: High School Diploma or Equivalent
• Minimum Years of Experience: 4 Years of clinical or hospital experience; 2 Years of experience in quality or utilization review.
• Required Certifications/Licensure: Registered Nurse (RN)

Essential Functions:

• Utilizes in-depth knowledge of clinical workflows, policies and procedures, patient care / clinical business processes, regulatory requirements, and best practices to:
• Risk Management:
• Perform daily review of new occurrence reports.
• Identify occurrences that require additional follow-up and reports these to the Director or designee in a timely manner.
• Ensure that occurrences are categorized correctly and all fields completed and correct.
• Verifies data accuracy with medical record if necessary.
• Ensure that occurrence reports are forwarded to all appropriate persons.
• Access other sources of data as needed for investigation and follow up.
• Serves as System Administrator for the occurrence reporting system.
• Primary liaison between Risk Management, Information Services, and system users.
• Manages access to the occurrence reporting system.
• Adds new locations and new users and provides new-user training.
• Assigns passwords.
• Removes users as needed.
• Provides new user training and ongoing user support, paying keen attention to user needs and opportunities to offer solutions and modify processes to improve efficiencies.
• Coordinates with vendor and Information Services to troubleshoot system as needed.
• Center for Best Practice & PN Quality:
• Assists with development, implementation, and evaluation of the hospital's overall quality improvement program.
• Assist with coordination, preparation, and maintenance of performance improvement assessment and improvement activities.
• Responsible for data integrity and follows well defined processes for maintaining data integrity as well as manage assigned database.
• Assists in evaluation, analysis, maintenance and development of system functionality of the EHR to meet clinical objectives including participating in project plan development/tracking and workflow analysis.

We are committed to offering quality, cost-effective benefits choices for our benefit eligible employees and their families:

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one.
• LHI matches dollar for dollar up to 6%.
• Employer paid life insurance equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Tuition reimbursement
• Student loan forgiveness

Equal Opportunity Employer

It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee's desires and abilities and the hospital's needs.