Identify and report to the EPRP Quality Assurance Coordinator for submission to the Southern and Northern California Divisions KP facility QA/Risk Management Coordinators regarding quality and risk ...
Identify and report to the EPRP Quality Assurance Coordinator for submission to the Southern and Northern California Divisions KP facility QA/Risk Management Coordinators regarding quality and risk ...
The Joint Commission (TJC), Veteran Integrated Service Network {VISN) Clinical Reviews, EPRP, CMS Care Compare, and Facility Performance Plans). Other duties include but not limited to the following:
The Joint Commission (TJC), Veteran Integrated Service Network {VISN) Clinical Reviews, EPRP, CMS Care Compare, and Facility Performance Plans). Other duties include but not limited to the following:
Physician (Pulmonologist)
$288K - $384K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Physician (Pulmonologist)
$288K - $384K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Actively involved in improvement of quality measures such as EPRP, timely access to care, OR efficiency, cancellation rates, length of stay, etc. * Other related duties as assigned. * Position ...
Actively involved in improvement of quality measures such as EPRP, timely access to care, OR efficiency, cancellation rates, length of stay, etc. * Other related duties as assigned. * Position ...
Physician, Hematology/Oncology
Columbia, SC · On-site +1
$300K - $400K/yr
Participates in hospital and medical staff activities such as accreditation requirements, quality assessment, quality improvement projects, committee assignments, EPRP activities, lean activities ...
Physician, Hematology/Oncology
Columbia, SC · On-site +1
$300K - $400K/yr
Participates in hospital and medical staff activities such as accreditation requirements, quality assessment, quality improvement projects, committee assignments, EPRP activities, lean activities ...
Actively involved in improvement of quality measures such as EPRP, timely access to care, OR efficiency, cancellation rates, length of stay, etc. Other related duties as assigned. Position reports ...
Actively involved in improvement of quality measures such as EPRP, timely access to care, OR efficiency, cancellation rates, length of stay, etc. Other related duties as assigned. Position reports ...
Physician, Hematology/Oncology
Columbia, SC · On-site
$179K - $213K/yr
Participates in hospital and medical staff activities such as accreditation requirements, quality assessment, quality improvement projects, committee assignments, EPRP activities, lean activities ...
Physician, Hematology/Oncology
Columbia, SC · On-site
$179K - $213K/yr
Participates in hospital and medical staff activities such as accreditation requirements, quality assessment, quality improvement projects, committee assignments, EPRP activities, lean activities ...
Participates in hospital and medical staff activities such as accreditation requirements, quality assessment, quality improvement projects, committee assignments, EPRP activities, lean activities ...
Participates in hospital and medical staff activities such as accreditation requirements, quality assessment, quality improvement projects, committee assignments, EPRP activities, lean activities ...
Branch Office Case Manager
Tyler, TX · On-site
Ability to work flexible schedule as the need arises for after hours operational policies and procedures such as EPRP, etc. Physical and Mental Effort: Prolonged sitting required with ability to ...
New
Quick apply
Branch Office Case Manager
Tyler, TX · On-site
Ability to work flexible schedule as the need arises for after hours operational policies and procedures such as EPRP, etc. Physical and Mental Effort: Prolonged sitting required with ability to ...
New
Registered Nurse - Deputy Chief of Quality Management
West Palm Beach, FL · On-site +1
$168K - $224K/yr
This includes providing clinical and administrative recommendations relative to all Strategic Analytic Improvement Learning (SAIL) outcomes, External Peer Review Program (EPRP) metrics, and driving ...
Registered Nurse - Deputy Chief of Quality Management
West Palm Beach, FL · On-site +1
$168K - $224K/yr
This includes providing clinical and administrative recommendations relative to all Strategic Analytic Improvement Learning (SAIL) outcomes, External Peer Review Program (EPRP) metrics, and driving ...
Physician (Pulmonologist)
Las Vegas, NV · On-site +1
$300K - $348K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Physician (Pulmonologist)
Las Vegas, NV · On-site +1
$300K - $348K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Registered Nurse - Deputy Director Quality Management
Lebanon, PA · On-site +1
$135K - $180K/yr
This includes providing clinical and administrative recommendations relative to all Strategic Analytic Improvement Learning (SAIL) outcomes, External Peer Review Program (EPRP) metrics, and driving ...
Registered Nurse - Deputy Director Quality Management
Lebanon, PA · On-site +1
$135K - $180K/yr
This includes providing clinical and administrative recommendations relative to all Strategic Analytic Improvement Learning (SAIL) outcomes, External Peer Review Program (EPRP) metrics, and driving ...
Physician (Pulmonologist)
$288K - $384K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Physician (Pulmonologist)
$288K - $384K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Cardiothoracic Surgeon
Buffalo, NY · On-site +1
$340K - $380K/yr
Actively involved in improvement of quality measures such as EPRP, timely access to care, OR efficiency, cancellation rates, length of stay, etc. * Other related duties as assigned. * Position ...
Cardiothoracic Surgeon
Buffalo, NY · On-site +1
$340K - $380K/yr
Actively involved in improvement of quality measures such as EPRP, timely access to care, OR efficiency, cancellation rates, length of stay, etc. * Other related duties as assigned. * Position ...
Ability to work flexible schedule as the need arises for after hours operational policies and procedures such as EPRP, etc. Physical and Mental Effort: Prolonged sitting required with ability to ...
New
Quick apply
Ability to work flexible schedule as the need arises for after hours operational policies and procedures such as EPRP, etc. Physical and Mental Effort: Prolonged sitting required with ability to ...
New
Physician (Pulmonologist)
Las Vegas, NV · On-site
$288K - $384K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Physician (Pulmonologist)
Las Vegas, NV · On-site
$288K - $384K/yr
Engage in various hospital and medical staff activities, including accreditation, quality assessment and improvement projects, committee work, and participation in programs like EPRP, ORYX, HEDIS ...
Registered Nurse - Performance Improvement
Washington, DC · On-site +1
$82K - $157K/yr
Critical analysis of a variety of different VA and/or VHA outcomes databases including but not limited to VHA Support Service Center (VSSC), the External Peer Review Program (EPRP), Strategic ...
Registered Nurse - Performance Improvement
Washington, DC · On-site +1
$82K - $157K/yr
Critical analysis of a variety of different VA and/or VHA outcomes databases including but not limited to VHA Support Service Center (VSSC), the External Peer Review Program (EPRP), Strategic ...
Critical analysis of a variety of different VA and/or VHA outcomes databases including but not limited to VHA Support Service Center (VSSC), the External Peer Review Program (EPRP), Strategic ...
New
Critical analysis of a variety of different VA and/or VHA outcomes databases including but not limited to VHA Support Service Center (VSSC), the External Peer Review Program (EPRP), Strategic ...
New
Eprp information
What are the key skills and qualifications needed to thrive as an Entry Level Project Engineer (EPRP), and why are they important?
What types of projects or tasks can an Entry-Level Project Research Professional (EPRP) expect to work on in their first year?
What are EPRP professionals?
Other
Posted 5 days ago
Job description
To provide a centrally located and operated initiative for Kaiser Permanente (KP) Southern and Northern California Regions designed to help control emergency claims costs and maintain or improve quality of emergency care received by Health Plan members at non -Kaiser Permanente facilities nationwide. Will review for appropriateness situations, where a Health Plan member is receiving care in an emergency medical situations from community providers (in area and out of area). Will be using emergency medicine/critical care clinical experience and general guidelines, to determine whether to conditionally approve or deny care by community providers or whether to negotiate for lower level of care for the member or whether to refer to the SCPMG/TPMG MD on duty for review or whether to arrange transfer for medically stable members to a Kaiser Permanente Facility or Kaiser Permanente Contract Facilities.
- Prospective utilization review activities by reviewing cases with community emergency physicians and making decisions to conditionally approve or deny treatment and /or transfer Health Plan members with emergency needs.
- Also direct and assist members appropriately requiring urgent care level of medical needs.
- Encouraging limited patient work-up where practical to reduce out-of-plan expenditures and acting as a resource for the Claims Administration Department.
- Arrange critical care transport of critically ill/hemodynamically stable Health Plan members from community facilities (in area and out of area) to Kaiser Permanente Facilities for the Southern and Northern California Divisions.
- Assess available information and make quick appropriate/effective decisions regarding level of care required for Southern and Northern California Health Plan members.
- Notification to Couc /Outside Utilization Coordinators (Southern California Division) /Case Managers (Northern California Division) regarding non plan admissions of Health Plan members for medical issues/situations.
- Assist in the development and implementation of policies and procedures for the EPRP/Critical Care Transport Program.
- Identify and report to the EPRP Quality Assurance Coordinator for submission to the Southern and Northern California Divisions KP facility QA/Risk Management Coordinators regarding quality and risk management issues to effect favorable management of members thereby increasing member satisfaction.
- Document interactions and identify emergency medical claims to assure follow-through for the Claims Administration Department personnel for the Southern and Northern California Divisions.
- Assist as a liaison with all three Kaiser Permanente entities, KP contract providers and external providers to help ensure that members with high cost claims receive timely, coordinated, high quality and cost effective care.
- Two (2) years of nursing experience in Emergency Care/Critical Care required.
- N/A
- Registered Nurse License (California)
- Knowledge of computers, ability to utilize various software as required.
- Excellent written and verbal skills.
- Demonstrated ability to communicate effectively in an understandable manner telephonically and in writing.
- Demonstrated ability in planning, organizing, conflict resolution, negotiating and interpersonal skills.
- Autonomous professional with minimal need for direct supervision.
- One (1) year Pediatric or Pediatric Critical Care experience or one (1) year Level III Neontatal Critical Care experience.
- Bachelors degree in nursing or healthcare related field preferred.
Notes:
- No Benefits
- May rotate to two additional assignments in ETAP and PTAC.
- Option II
- This is a temporary position for approximately 90 days