Medical Staff Peer Review & Facility Enrollment Coordinator REMOTE

Position Summary

In the role of Medical Staff Peer Review Coordinator and Facility Enrollment, the incumbent coordinates and facilitates the medical and allied health staff peer review process to ensure quality, safety, and regulatory compliance. This includes managing FPPE (Focused Professional Practice Evaluation) and OPPE (Ongoing Professional Practice Evaluation) for physicians and advanced practice professionals, organizing review activities, maintaining documentation, and supporting continuous quality improvement initiatives.

As the Facility Enrollment Specialist, the Coordinator manages enrollment processes for the hospital’s facilities, ensuring proper enrollment with insurance payers, government programs, and other entities to enable timely reimbursement.

• Bachelor’s degree in healthcare administration, nursing, or related field.
• 5 years of experience in an acute hospital setting.
• 2-3 years of experience in Peer Review, Quality, Patient Safety, and Facility Enrollment preferred.
• Certified Peer Reviewer preferred certification.

Bachelor’s degree in healthcare administration, nursing, or related field.

• Certified Peer Reviewer.

Preferred certifications, credentials, and licenses beyond the core requirement.

• Knowledge of medical staff processes, healthcare quality assurance, and regulatory standards.
• Strong organizational, analytical, and communication skills with attention to detail.
• Experience with healthcare documentation and data management systems.
• Familiarity with accreditation standards (e.g., The Joint Commission) and regulatory requirements.
• Discretion and confidentiality in handling sensitive information.

• Peer Review: Coordinate the peer review process for medical staff, including scheduling, communication, and documentation, and maintain peer review data and reports in compliance with policies.
• Assist medical staff and reviewers to ensure timely and thorough assessments.
• Facilitate communication among medical staff, hospital administration, and review committees; prepare summaries, reports, and follow‑up documentation.
• Analyze practitioner performance data and prepare reports for leadership; identify trends and improvement areas.
• Support compliance with accreditation standards and develop policies and procedures related to peer review.
• Educate physicians and providers on FPPE and OPPE processes.
• Ensure confidentiality of peer review information.

• FPPE/OPPE: Oversee implementation and administration of FPPE and OPPE programs.
• Collect, review, and document practitioner performance data; monitor OPPE activities.
• Gather data from peer reviews, patient outcomes, incident reports, and quality metrics.
• Prepare reports for medical staff leadership and hospital administration.
• Act as liaison between medical staff, quality improvement, credentialing, and administrative departments.
• Maintain documentation to support accreditation and licensing audits.

• Facility Enrollment: Prepare and submit enrollment applications; maintain accurate entity records; track application statuses and resolve issues.
• Ensure compliance with all payer and regulatory requirements; assist with periodic audits of provider files.
• Serve as Administrator and Primary Contact with payers and entities related to facility enrollment.

• Software: Administrator, SME, and liaison with Symplr-Data Vision, StatIT, Cactus-Peer Review, and other peer review software.