Loan Review Manager jobs in Colorado

All the benefits and perks you need for you and your family:

Benefits from Day One

• Paid Days Off from Day One

• Student Loan Repayment Program

• Career Development

• Whole Person Wellbeing Resources

• Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule: Full time

Shift: Day

Location: 7700 South Broadway, Littleton, CO 80122

The community you’ll be caring for: AdventHealth Littleton

The role you’ll contribute:

The purpose of the Peer Review Program Manager position is to ensure quality patient care by effectively managing the Medical Staff’s Peer Review Program, which encompasses the ongoing and focused professional performance review processes, the clinical care case referral/disposition processes, and the professional conduct case referral/disposition processes. Due to multiple Medical Staffs and facilities, this Program Manager must establish many effective relationships, work within multiple organizational structures and cultures, manage various systems/policies, and move between facilities with ease. They manage multiple Medical Staffs in the functioning for analyzing practitioner-specific patient care data (case referrals, medication safety, mortality review, length of stays, occurrences, complaints, etc.). Ensures the Medical Staff’s education and knowledge in methodologies of data management and interpretation, for the purpose of improving patient care.

This position administers a regulatory-compliant, effective and efficient peer review program, from data gathering through facilitating the Medical Staff’s governance systems in the area of peer review. These functions involve support to and communications with numerous hospital departments, executive administration, and the governing board, pursuant to the requirements set forth in Medical Staff Bylaws and Federal/State laws. The Peer Review Program Manager must direct, educate and motivate physician leaders to accomplish their assigned tasks either with matters of significance to department business or in support of the credentialing program. The position is also responsible for the integration of services between the MSSD, IT and Quality Departments with regards to the peer review program.

The value you’ll bring to the team:

• Administers a regulatory-compliant, effective peer review program, from data maintenance/mining in the EMR through facilitation the entire due process
• Aggregates, analyzes, presents and maintain practitioner specific quality data.
• Communicates with each practitioner to ensure records are identify and analyzed for the evaluation of competence.
• Researches and prepares case synopsis for assignment to Committee for initial evaluation of referred cases.
• Coordinates agendas and facilitates Peer Review Committee meetings; creates all documentation/materials and communicates directly with involved practitioners.
• Develops, implements and improves the processes and procedures for the Focused and Ongoing Professional Practice Evaluations of the medical staffs and advanced practice providers.
• Creates standard processes and procedures to track timely completion of peer and medical staff quality reviews.
• Maintains FPPE and OPPE reports and processes.
• Responsible for the integration of services between the Medical Staff, IT and Quality departments with regards to the peer review program, including peer and medical staff quality review findings into the credentialing reappointment process in conjunction with TJC standards.
• Represents the Medical Staff in regulatory readiness plans/committees for TJC, CMS and DOH.
• Researches and develops relevant and appropriate educational activities based upon the outcomes of peer review findings.
• Identifies and accumulates data for analyses for practitioner specific review, procedural trends and rule rate indicates.
• Obtains clinical evidence from appropriate literature or standards and comparison information from relevant databases.
• Evaluates, verifies and challenges when appropriate, the aggregated data to ensure the integrity of the program.
• Identifies and reports our negative trends or individual incidents to mitigate the organization’s risk.
• Collaborates with Medical Staff leaders to determine action plans, implements and documents action plans and ensure follow- up.
• Maintains current knowledge of the Medical Staff Bylaws, Rules and Regulations, and Peer Review Policies, as well as Peer Review/OPPE/FPPE requirements from TJC to meet all standards, serving as a technical resource to the Medical Staff.
• Promote a team environment, willing to assist others, and responds timely to physicians, hospital staff and various external entities.
• Responsible for protection of highly confidential and sensitive information, including peer review and HIPAA protected information.
• Establish productive relationships with various stakeholders to ensure compliance and effective systems.

The expertise and experiences you’ll need to succeed:

Minimum qualifications:

High School diploma or GED or 1 year work experience

Associate’s degree or Bachelor's degree in healthcare related field strongly preferred; in lieu of degree, 2 years of experience in healthcare related field

Preferred qualifications: