Peer Review Program Manager

LOCATION: Columbia, Missouri

ABOUT THE JOB

The Peer Review Program Manager will support all aspects of MU Health Care's Peer Review and Professional Practice Evaluation Program by identifying clinical competence thresholds, opportunities, and processes to achieve improvement, while developing strategies to enhance clinician performance. The duties of this position require utilizing feedback from Medical Staff leaders and team members, Department Chairs, Division Directors, and other stakeholders to develop key performance indicators (KPI) and monitor appropriate progress toward those KPIs.

SALARY RANGE $68,266 - $111,426

ABOUT US

MU Health Care is a growing academic health system in mid-Missouri comprised of multiple hospitals - including the region's only Level 1 Trauma Center and region's only Children's Hospital - and over 50 specialty clinics located throughout the region.

As an MU Health Care employee, you will be part of an exceptional team committed to our mission of saving and improving lives and supporting our team members to achieve their personal and professional goals. Our core values of inclusion, respect, service, discovery, responsibility, and excellence foster a collaborative work environment where you can grow your career.

Learn more about MU Health Care. Learn more about living in Columbia, MO.

EMPLOYEE BENEFITS

Health, vision, and dental insurance coverage starting day one

Generous paid leave and paid time off, including 9 paid holidays

Multiple retirement options, including 100% match up to 8% and full vesting in three years

Tuition assistance for employees (75%) and immediate family members (50%)

Discounts on cell phone plans, rental cars, gyms, hotels, and more.

See a comprehensive list of benefits here.

ESSENTIAL FUNCTIONS

• Act as liaison between MU Health Care and School of Medicine clinical department leaders to develop, monitor, and analyze practitioner-specific performance data used in the periodic assessment of professional clinical practice at MU Health Care, including key performance indicators and clinical competency thresholds.

• Coordinate and manage the collection of clinical data required for periodic assessment of professional practice to evaluate initial and continued clinical competencies as well as improvement opportunities by utilizing MU Health Care, School of Medicine, and national comparative to identify individual or process discrepancies, data inconsistencies, or variation from defined criteria/benchmarks established by the medical staff.

• Manage the ongoing/focused professional practice evaluation (OPPE/FPPE) process for all privileged practitioners. Publish individual and aggregate performance dashboards to analyze and refer outliers to the appropriate quality, credentials, and peer review committees. Support the process of determining whether existing individual privileges will be renewed or require modification/amendment. Create, revise, or maintain policies and protocols addressing identified variations, including medical staff determination of validity, written explanation of findings, and, if appropriate, an action plan to include improvement strategies, the need for further training or proctoring, or amendment to privileges.

• Enter and manage performance and peer review data within electronic credentialing and privileging systems.

• Assures the confidentiality, protected status, and integrity of all aspects of Peer Review and Professional Practice Evaluation programs and provides special or routine reports to demonstrate individual or systemic successes or deviations through evaluation tools.

• Ensure continuous compliance with regulatory bodies such as CMS, DNV, and NCQA for applicable regulatory requirements, including consulting with regulatory bodies to demonstrate compliance.

• Communicate successes and deviations to practitioners and their department and medical staff leaders.

• Assist in facilitation of Peer Review Meetings including preparation, attendance, feedback communication, transcription of minutes, and all other aspects of meetings.

• Assist the Director of Medical Staff Affairs & Graduate Medical Education (GME) in the coordination and completion of special projects (i.e., medical staff adverse privileging actions, hearings, or professional review activity). Occasionally, serve in the absence of the Director.

• May complete unit/department-specific duties as outlined in department documents.

REQUIRED QUALIFICATIONS:

Bachelor's degree in business, health administration, finance.

Three (3) years of experience with medical staff credentialing, quality improvement, risk management, HR, analytics, or project management.

Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM) or other leadership certification by the National Association of Medical Staff Services (NAMSS) within six (6) years of hire as a condition of continued employment in this job classification.

PREFERRED QUALIFICATIONS:

Additional license/certification requirements as determined by the hiring department.