Job Description


The Metabolic and Bariatric Surgery Clinical Reviewer is responsible for identification of 100 percent of the metabolic and bariatric surgery patients for inclusion in the MBSAQIP data platform.  Responsibilities include collection of preoperative, intraoperative, 30 day postoperative, and long-term (six month and annual thereafter follow-up data components for the program through the effective utilization of the hospital medical record systems and through a coordinated effort with individual surgeon office staff. Data submitted to the MBSAQIP Data Registry Platform must be accurate, complete and timely.




1.      Consistently supports and communicates the Mission, Vision, and Values of St. Joseph Medical Center (SJMC).


2.      Follows the SJMC guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).


3.      Promotes a culture of safety for patients and employees through proper identification, proper reporting, and documentation in a non-punitive environment.



4.      Assists in SJMC in the reaccreditation process and ensuring continuous compliance with MBSAQIP Standards for data collection.


5.      Identifies streamlining and process improvement opportunities in the data collection process.


6.      Demonstrates appropriate utilization of resources necessary to obtain valid, reliable data for entry into the MBSAQIP data registry platform.


7.      Utilizes software applications for data collection and analysis.



8.      Responsible for the accurate, complete and timely entry of data into MBSAQIP data registry platform.

9.      Works effectively with hospital and individual surgeon’s office staff.


10.  While serving as MBSCR, fulfills ongoing training and recertification requirements.


11.  Participates in the MBSAQIP program teleconferences.


12.  Participates in data compilation for audits and (re)accreditation or site visits.  



Leadership, Technical Ability, Initiative/Follow Through, & Flexibility:


1.            Supports the philosophy of SJMC by facilitating cooperation of hospital staff in a multi-disciplinary approach to patient care.

2.            Consistently provides outstanding service to all patients, physicians, fellow employees, and guests.

3.            Displays initiative to see processes through to completion and offers assistance without being asked.

4.            Maintains awareness of own limitations and seeks guidance from appropriate personnel as needed.

5.            Prioritizes activities of self based on demands for service.

6.            Remains alert to the detection of errors in own work.

7.            Demonstrates an understanding of patient rights, including those pertaining to confidentiality, informed decision-making, and privacy.

8.            Is aware of resources available for ethical concerns and makes appropriate referrals.

9.            Practices cost-efficiently.

10.        Performs technical skills proficiently in accordance with established standards, as evidenced by annual validation processes.

11.        Utilizes specialized knowledge and skill to perform job requirements.

12.        Interprets, implements, supports, and enforces the program's compliance with MBSAQIP standards.

13.        Develops goals and objectives annually, and as needed.

14.        Maintains cooperative working relationships with the program, and with other hospital departments and services.

15.        Submits all requested reports in a timely manner.

16.        Performs other duties as assigned.


Communication, Customer Focus, and Teamwork:


1.            Communicates effectively with patients, physicians, hospital personnel, and others to fulfill position responsibilities.

2.            Actively participates in hospital and departmental group meetings.

3.            Consistently responds to requests in a positive, professional, and timely manner.

4.            Consistently demonstrates behavior which reflects that working as a team is more important than self-interest.

5.            Demonstrates interpersonal competencies such as effective problem-solving, negotiation, and conflict management skills.

6.            Consistently maintains a professional level of conduct.

7.            Facilitates communication with patients, physicians, guests, and co-workers.

8.         Consistently demonstrates courteous and positive behaviors, e.g. smile, pleasant tone of voice, positive eye contact.

9.         Utilizes appropriate lines of accountability for the continuous improvement of quality.

10.     Ensures that problems/concerns regarding activities in the hospital are communicated appropriately.

11.     Protects confidentiality of patients/co-workers, respecting their dignity, privacy, and differences.

12.     Shows respect for hospital property and the property of others.

13.     Actively contributes to the hospital mission and philosophy of patient care.

14.     Demonstrates strong verbal, written, and problem-solving skills.

15.     Directs weekly team meetings to plan marketing and community relations activities as well as discuss patient care issues.

16.     Effectively manages time by prioritizing demands and utilizing time efficiently.


Personal Development/Learning Focus:


1.         Assumes responsibility for professional growth and development of self, utilizing professional organizations, workshops, seminars, and other self-directed learning activities as applicable.

2.         Maintains awareness of current hospital and departmental operational policies and procedures which impact on responsibilities of position.

3.         Utilizes appropriate safety precautions and principles of good body mechanics at all times.

4.         Is knowledgeable of standards established by SJMC including, but not limited to: Fire, Safety, Infection Control, Disaster, and Universal Precautions.

5.         Assists with the development of all personnel on his/her shift, including unit specific orientation and continuing education.


Performance Improvement and Business Sense:


1.         Actively participates in both departmental and hospital-wide process improvement efforts.






  • Data collection and identification of areas for quality improvement requires clinical knowledge and understanding of patient care.  The candidate should have some clinical understanding of the bariatric patient.



  • Current license as Registered Nurse for the State of Texas (preferred)
  • MBSAQIP Clinical Reviewer Certification or obtain Certification within 90 days of employment.




  • MBSAQIP Clinical Reviewer Certification







  • The ability to learn and utilize new software and Web applications for data entry and report generation.  The candidate should have some computer experience with Microsoft office and basic statistical skills
  • The ability to track health information through various sources such as medical records, surgery clinics, death index, direct patient contact, accounts payable, and legal counsel. The candidate should have some experience gathering information in a complex hospital system environment.
  • The ability to identify opportunities to report metabolic and bariatric data relevant groups or meetings.  The candidate should have some experience sharing information across functions
  • Technical, and interpersonal skills relevant to area in order to effectively communicate with physicians, health team members, patients, and families.
  • Ability to prioritize work with minimal supervision, in order to independently carry out the duties of the position.
  • Excellent organizational skills.
  • Must have excellent oral and written communication skills.
  • Must be tactful and proficient in conflict resolution.
  • Must be able to work well independently and with a team.
  • Must be able to project a positive public image and be self-motivated.
  • Basic computer knowledge.
  • Customer focused skills (patient advocate).
  • Interpersonal skills.


Application Instructions

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