Quality Review RN - Clinic: Hoag Clinic Clinical Services

Quality Review RN

Join Hoag as a Quality Review RN, where you'll operate and continuously improve a comprehensive peer-review program that supports clinical excellence in outpatient care. In this highly collaborative role, you'll partner with physician leaders to drive quality and champion evidence-based care. This is an ideal opportunity for an innovative RN with strong analytical, communication, and coordination skills, and a passion for making an impact.

Responsibilities

What You'll Do

• Under the direction of the Director Clinical Services for Hoag Clinic, develops and coordinates an effective and continuously improving healthcare practitioner peer review program.
• Coordinates and oversees the process of performing objective medical record review of each case for appropriateness of care based on evidence-based clinical care guidelines, in collaboration with physician leadership.
• Coordinates and leads regular peer review body meetings.
• Ensures follow-up actions on each case are implemented, e.g., education/training, monitoring/proctoring, change in privileges, behavior counseling, or summary suspension/termination.
• Ensures peer review activities are timely and meet all internal requirements and are compliant with external standards and regulations, state laws and Medicare Conditions of Participation.
• Maintains complete and accurate records of peer review activities.
• Develops and oversees operational quality indicators.
• Assists the Director Clinical Services in preparation of reports and presentations.
• Utilizes superior discretion and appropriate safeguards to maintain confidentiality and prevent inappropriate use or disclosure of sensitive information.
• Performs other duties as assigned.

Qualifications

What You'll Bring

Education and Experience

Required:

• Bachelor's degree in nursing or another healthcare field
• At least five (5) years clinical experience
• At least one (1) year experience in quality and/or risk management work
• Highly proficient with Microsoft Office suite of products, including Word, Excel, Outlook, and PowerPoint
• Experienced user of Electronic Health Records (EHR)
• Comprehensive knowledge of medical terminology

Preferred:

• Experience with EPIC
• Experience in database management

Licenses Required

• Current licensure as a Registered Nurse in good standing in the State of California

Certifications Required

• N/A

Certifications Preferred

• Certified Professional in Healthcare Quality (CPHQ) or Certified Professional Medical Services Management (CPMSM)
• Position may require local travel between various organization locations

Travel

• Position may require local travel between various organization locations

About Us

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County's health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag's awards and accreditations, visit:

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.

Job Info

• Job Identification 128220
• Job Category Project Mgmt, Quality & Compliance
• Locations 2975 Red Hill Ave, Costa Mesa, CA, 92626, US
• Pay Range $49.15-$75.94/hour
• Remote or Onsite Onsite
• Job Schedule Full Time