The Medical Staff Practitioner Evaluation Specialist provides expert consultation, collaborative development and implementation of all practitioner peer
review activities. This includes supporting the medical staff practitioner evaluation activities through identifying and preparing cases for practitioner evaluation. This position promotes and maintains a systemic method to support Ongoing Professional Practice Evaluations and Focused Professional Practice Evaluations (OPPE/FPPE) at a system level to meet Joint Commission accreditation standards and provide a mechanism to provide practitioner performance feedback. Facilitates interdisciplinary collaboration to ensure OPPE and FPPE quality metrics are meaningful and appropriate for all service specialties. Develops process improvement initiatives and maintains regulatory compliance.
Supports and facilitates the medical staff peer review process through identifying and preparing cases for review, which includes analyzing cases meeting peer review indicators or care concerns, and facilitation of peer review meetings
Coordinates review activities with medical staff leaders, written and oral communication with reviewers, management of highly sensitive information and other duties as directed by the VPMA and Director of Medical Staff Services.
Assists and provides direction for the development of medical staff clinical indicators with which to monitor and evaluate the quality of care and services rendered by practitioners.
Coordinates and facilitates external peer reviews as needed
Communicates Peer Review findings and determinations with provider(s) involved in the case(s) reviewed
Maintains documentation of findings and outcomes in the secure data reporting system
Ensures compliance with applicable regulatory guidelines and requirements, state and federal statutes, and medical bylaws, rules and policies.
Provides information and education on the peer review process to medical staff as necessary.
Identifies organizational process improvement opportunities using data and information gained through entity needs assessment process