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

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