Care Review Resources Careers
Our passion is providing quality service. We are able to do this with data abstraction and core principles of how the patient should be treated. We will not compromise our standards. Our data will ensure complete transparency while maintaining a great working relationship with our partners and patients.
The Associates possess applicable credentials, licenses, certifications.
If you are looking for a career with a company that will exceed your expectations look no further.
Coordinator, Quality Peer Review (LVN/RN), Quality Assurance
This position is available for remote work from 20-40 hours a week.
Essential Job Outcomes & Functions:
- Conduct primary or secondary screening of patient care variances to identify those cases warranting physician review.
- Evaluate variance of monitoring 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 Crimson, MS Excel, MS Word, MS Outlook, etc.
Minimum Requirements / Work Experience:
- Minimum three years’ experience in acute hospital setting
- CA issued RN license required
- Previous UR/QA/QI/RM/Case Management experience required
- Knowledge of various agencies and regulations pertaining to TJC, CMS, CDPH, CCS, Medi-Cal, IMQ, etc.
- Minimum three years with computer applications/software Microsoft Office preferred
- Word, Excel (intermediate level user), Outlook
- EMR Experience – EPIC (Inpatient and outpatient)
Experienced Quality Nurses – Peer Review
Care Review Resources, Inc has an immediate need for 2 on-site RN’s with relevant and recent experience in Peer Review for our client. Hours can be flexible. On-site initially, moving to remote once client is caught up. These are contractual positions; however, hours will be full-time initially.
- Assist in getting caught up on entering and finishing hospital audits for OPPE: C-section, Hips and Knees, Bariatrics, CABG (we’ve 2019 complete), ED mortality, PEDs mortality, House mortality, Procedural sedation, PSI’s, H & P’s / Op reports from HIM and ATLAS reports for credentialing
- Review Core Measures fall outs
- Send follow up letters
- Enter data into MIDAS
- Teach and assist Client Responsibilities how to use ATLAS
- RN with current license
- 5+ years experience in Quality at hospitals
- Relevant and recent experience in Peer Review
- Pass complete background and drug screening, TB test
- Very Comfortable in MIDAS, CERNER, the OPPE, Peer review/FPPE process
- Knowledge of HIPAA compliance
Patient Safety, Risk Management Officer
Position Type: On-site
Location: Southbay, Los Angeles
Contract Duration: 1-3 months, Full-time
Key job functions:
- Oversees the facility’s patient safety program including updating the Patient Safety Plan
- Oversees Risk management activities
- Provide patient safety education at new hire orientation and for continuing improvement to all staff and leaders
- Identifies initiatives and programs to mitigate risks to reduce adverse patient outcomes, safer patient care and reduced costs.
- Ensure all accreditation and regulatory requirements for patient safety are fully met.
- Oversees event reporting, root cause analysis and event investigation and review
- Collect, analyze and report data on patient safety and risk events
- Receives and responds to patient complaints and grievances and works to resolve issues promptly
- Acts as intermediary among patients, staff and family to provide clear communications
- Coordinates claim requests and resolutions
- Prepares informative and actionable patient safety reports for presentation to appropriate committees and board of directors
- Oversee the coordination of all legal documents related to hospital liability.
- Assist with regulatory visits
- Assist with providing advice and guidance to the clinical staff and physicians of regulatory guidelines, reviewing policies and procedures
Risk Management experience requirements:
- Knowledge of processes, tools and techniques for assessing and controlling organization’s exposure to various kinds of risks
- Knowledge of risks that may affect patients in the health care environment.
- Knowledge of reporting agencies for patient safety issues and near miss incidents.
- Knowledge of federal, state, and local healthcare agency laws and regulations related to risk management and patient safety
- Minimum of a valid RN or LVN license. Bachelor’s degree in nursing or related job/industry experience preferred.
- Minimum of three years or risk management, patient safety officer experience.
- Ability to work collaboratively with other members of the health care team, patients and families