CLINICAL QUALITY SPECIALIST

Cayuga Health and its affiliates are the region’s leading healthcare system and most trusted providers of integrated health services, empowering our people in our mission to equitably improve the well-being of the communities we serve. Our commitment to providing extraordinary healthcare begins with our team of extraordinary professionals who are continuously discovering clinical innovations and enhancing access to the most up-to-date facilities, equipment, technologies, and research protocols. Cayuga Health’s commitment to our employees includes competitive compensation, comprehensive employee benefits programs, and the opportunity to explore and build a career in healthcare through our many professional development programs.
The Clinical Quality Specialist, also referred to as Peer Review Specialist, will play a critical role in ensuring the highest standards of clinical care across our Centralus Health, a five-hospital system with 90 ambulatory clinics. This position demands a highly skilled and autonomous clinical professional who can independently coordinate and conduct peer reviews, analyze clinical outcomes, and identify opportunities for improvement. The Peer Review Specialist will be a key driver in promoting best practices and mitigating clinical risks, working closely with healthcare providers to foster a culture of continuous improvement. This role requires a proactive individual with strong clinical evaluation capabilities, excellent analytical skills, and the ability to effectively communicate and operationalize process.

REQUIRED SKILLS AND EXPERIENCE:

• Education: Bachelor’s degree in Nursing or a clinical field. Advanced degree preferred.
• Experience: Minimum of 5 years of experience in clinical risk management, peer review, or a related area within a healthcare setting. Will also accept experience as a clinical nurse specialist or clinical quality work over the course of 3 years.
• Skills: Strong analytical skills, excellent communication and interpersonal abilities, proficiency in data analysis and reporting, and familiarity with healthcare regulations and standards.
• Certifications: Certification Professional in Healthcare Risk Management (CHRM) or Certified Professional in Healthcare Quality (CPHQ) required. Candidates without these certifications must obtain them within two years of employment.

PHYSICAL REQUIREMENTS:

• Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally.

LOCATION AND TRAVEL REQUIREMENTS:

• Hybrid/In-Person - (approximately 80% remote with 20% on site)
• Primarily office-based with occasional travel to hospitals and clinics within the system. Flexible hours may be required to accommodate peer review meetings and training sessions.
• Travel: Required within the various Centralus Health locations.

• Coordinate Peer Review Process: Organize and facilitate peer review meetings, ensuring timely and thorough evaluations of clinical cases.
• Clinical Case Analysis: Review and analyze clinical cases to identify trends, patterns, and areas for improvement.
• Documentation: Maintain accurate and comprehensive records of peer review activities and outcomes.
• Collaboration:
• Work closely with peer review chairs and medical directors/medical officers to ensure collaboration throughout the peer review cycle.
• Ensure that the Medical Staff Office maintains compliance with the peer review process.
• Work collaboratively with healthcare providers, clinical staff, and administrative personnel to implement recommendations from peer reviews.
• Teaching and Coaching: Develop and deliver training programs to enhance clinical staff’s understanding of peer review processes and clinical risk management. Provide ongoing coaching and support to healthcare providers to foster continuous improvement and adherence to best practices.
• Compliance: Ensure compliance with regulatory requirements and hospital policies related to peer review and clinical risk management.