Practice Evaluation Specialist III

Practice Evaluation Specialist III (Clinical)

About Chartis

Chartis comprises 1,000 professionals who value working for a purpose-driven organization, people who have committed their careers to helping providers, payers, technology innovators, retail companies, and investors create and embrace solutions that reshape healthcare for the better. We work with over 900 clients annually to help make US healthcare more affordable, accessible, safe, and human.

Through our family of brands—Chartis, Jarrard, Greeley, and HealthScape Advisors—we have created a culture that prioritizes respect for our clients, commitment to each other, and unwavering integrity. From physicians, nurses, healthcare executives, and community health leaders to strategists, digital advisors, transactions experts, and healthcare futurists, we bring a diverse set of perspectives to assess healthcare challenges from every angle.

Believing in what we do helps us attract and retain the best and brightest because the work we do every day makes a meaningful impact. This theme of believing in a better way forward is woven into our brand, Believe in better.

Chartis has offices in Boston, Chicago, New York, San Francisco, Washington D.C., and Nashville. Remote work is allowed.

Role Overview

Under the general direction of the Director, Medical Staff Services and the Chief Medical Officer, this position is responsible for managing the coordination of internal and external provider peer review. Duties include comprehensive quality review of the electronic medical record (EMR), abstraction, appropriate and accurate documentation of findings and review and analysis of clinical indicators related to practitioner medical management and practice patterns. Supports the quality program to meet Joint Commission, CMS, Medical Staff Bylaws, and other regulatory requirements. Compiles data to evaluate the initial and ongoing quality of care and competency of the Medical Staff. Aggregates and reports clinical competency and other data to Medical Staff leadership and hospital leadership. This coordinator must possess excellent communication skills for data presentation and reporting to various Medical Staff and hospital committees. The coordinator must have superior communication skills to provide data and education to Medical Staff Chiefs and providers based upon peer review findings and audit results. Must possess critical thinking skills.

Responsibilities

• Exemplifies Mission Hospital and CHOC at Mission values and Service Excellence standards. Commits to making every encounter with our patients, patients’ family, co-workers, physicians, and other customers the best that it can be.

• Complies with all Mission Hospital and CHOC at Mission policies and the Code of Business Conduct. Maintains current tuberculosis testing. Takes responsibility for own safety as well as the safety of patients, patients’ family, co-workers, physicians, and other customers.

• Responsible for reviewing cases generated by chosen indicators or referred by other sources.

• Generate peer review worksheets and assign them to appropriate committee for review.

• Facilitate timely review, case action(s) and completion of reviews in collaboration with Medical Staff Department Chairs and/or their designees, Committees, and Administration.

• Collaborate and coordinate with Medical Staff Services Practice Evaluation Specialists in fulfillment of the responsibilities to support an effective and continuously improving medical staff peer review program.

• Keeps abreast of (TJC/CMS) Medical Staff Standards in relation to peer review educates medical staff leaders, hospital leaders and providers, fostering a commitment to compliance with these programs throughout the hospital.

• Participate in the following:

  • Mandatory training requirements as per hospital/unit policy.

  • Continuing education/in-services to enhance knowledge

  • Performance improvement initiatives

  • Staff meetings

  • Orientation of new staff, students, and/or volunteers

Qualifications and Desired Skills

• Strong knowledge of clinical practice and/or hospital operations required.

• EPIC experience

• Degree in nursing or related healthcare field, preferred. Minimum of two years of clinical experience.

• Working knowledge of the following: peer review process, including confidentiality, physician rights and hospital by-laws; disease and healthcare processes; and review of medical record content and hospital, State and Federal regulations regarding patient rights and confidentiality.

• Experience in patient safety initiatives, clinical quality process improvement, and new program/initiative development, implementation and evaluation.

• Basic understanding of the research process and statistical analysis.

• Strong interpersonal skills; leadership/mentoring skills; ability to communicate effectively with all levels of management and staff across the System; and strong oral and written communication skills including presentation skills.

• Proficient computer skills with extensive experience using various software applications such as Microsoft Word, Excel, and Outlook; experience with clinical/healthcare software applications preferred; demonstrated knowledge and skills in statistical presentations.

Salary range: $80,000 - $100,000, plus may be eligible for an annual discretionary bonus. The salary range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skills, experience, training, licensure and certifications, practice area, and other business and organizational needs. In addition, Chartis offers several benefits including medical, dental, vision, HSA, FSA, disability insurance, life insurance, 401(k) match, paid time off, wellness stipend, and additional voluntary benefits.

At Chartis, we pride ourselves on having a diverse workforce. We value and celebrate the uniqueness of individuals and the different perspectives they provide. We offer equal opportunity employment regardless of race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, disability status, age, marital status, or protected veteran status.