Essential Job Outcomes & Functions:

• Conduct primary or secondary screening of patient care variances to identify those cases warranting physician review.
• Evaluate variance of montioring functions to identify those meeting criteria for physician review (mortality, morbidity, blood usage, infection, adverse drug reactions, unusual occurrences).  
• Initiate periodic physician review of screening criteria to validate currency, relevance and appropriateness.  
• Coordinates statistical process review of selected diagnoses and procedures for medical staff review.
• Initiate referral process to the appropriate medical staff peer review group in coordination with medical staff coordinator:
• Prepare individual case referrals for physician review with appropriate supporting, background documentation.
• Work through medical staff coordinator to facilitate timely referrals, initiate measures to promote a thorough physician review with an objective outcome.
• Attend multidisciplinary medical staff peer review committee meetings as cases are presented and reviewed.  
• Enter outcomes of physician peer review into appropriate software system.
• Provide summary reports to medical staff committees, as well as physician specific reports for credential committee and physician profiles.
• Liaison with Quality Department and External Payors as needed to orchestrate response to quality issues identified by external payors.
• Disseminate information in a timely manner to applicable individuals.
• Assist with continuous readiness activities.
• Consistently applies infection control policies/procedures.
• Meets population specific competencies.  
• Attends department education/training in-services.
• Participates in specific performance improvement projects.
• Perform data management activities/documentation.
• Utilizes appropriate applications such as QualCare, Crimson, Excel, etc.