RN Peer Review Analyst, Qualtiy Review, Full Time, Days

PIH Health; California; On-site; USD 97,000 - 118,000; Full time

Benefits offered by this job

Health insurance

Job summary

PIH Health seeks an RN Peer Review Analyst to conduct retrospective medical record reviews ensuring quality and the accuracy of documentation. You will audit admissions and stays, monitor hospital metrics, and engage with physicians and staff to improve charting.

Strong analytical and interpersonal skills are essential. Required California RN license and knowledge of Medicare rules; a City Fire Card is expected within 6 months.

Qualifications

• LA City Fire Card within 6 months of employment.
• Current California RN license.
• Experience with chart review and quality management preferred.

Responsibilities

• Retrospectively review medical records to validate quality, appropriateness, and documentation accuracy.
• Audit charts for admission, continued stay, and hospital metrics.
• Interact with physicians, nurses and other professionals regarding chart documentation.
• Participate in team meetings to improve charting for physicians and clinical staff.
• Follow up on cases not meeting approved guidelines.

Skills

Organizational skills

Analytical skills

Interpersonal skills

Writing skills

Regulatory knowledge

Medicare knowledge

Problem solving

Communication with physicians

Education

California RN license

Nursing degree (BSN or higher) preferred

Tools

Windows-based software

Job description

Responsible for the retrospective review of medical records and compiling data to validate quality of care, appropriateness of care , and accuracy of documentation. RN Peer Review Analyst will audit charts for appropriateness of admission, continued stay, compliance to hospital metrics and to monitor care provided by our caregivers. RN Peer Review Analyst will interact with physicians, nurses and other professionals regarding chart documentation and actively participate in team meetings to help improve charting for physicians and clinical staff. Case found not meeting approved guidelines will be selected for peer review and follow up.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women's health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.

Required Skills

SPECIFIC SKILLS NEEDED

• Organizational, analytical, writing and interpersonal skills.
• Dependable and self directed.
• Critical thinking, problem solving and deductive reasoning skills.
• Basic computer skills - Familiarity with Windows based software programs.
• Knowledge of Medicare Part A and B.
• Understanding of regulatory environment.
• Understanding and supporting documentation strategies.
• Understand and communicate Medicare requirements and how they impact DRG assignment.

Required Experience

Required:

• LA City Fire Card within 6 months of employment
• Current California RN license

Preferred:

• RN Degree in Nursing, a Bachelor's Degree or Master's Degree preferred.
• Five years of clinical chart review, conducting chart aults and working in Quality Managment, Case Managment, ED or ICU

Minimum Salary

$107,598.40