Overview
Job Summary
Coordinates the daily activities of the medical staff office which involves planning, developing and organizing the corporate operations of the office and its contributions to meeting the mission and goals of the System. Demonstrates compliance with the medical staff bylaws, rules and regulations, joint commission standards, and other applicable federal, state and local regulatory and accrediting agencies.
Essential Functions
- Develops, manages and monitors processes and procedures that supports the centralized credentialing and reappointment of all providers.
- Serves as a resource for facilities medical staff committees.
- Ensures compliance with the accrediting and regulatory agencies in regards to credentialing while developing and maintaining a working knowledge of the statues and laws.
- Interfaces with leadership to guide and instruct them through the medical staff policies and procedures and regulatory requirements to ensure compliance.
- Collaborates with the credentialing coordinators in ensuring that all information presented to the medical staff and leadership is presented in an accurate and timely manner.
- Directs inquiries and coordinates functions in the leadership's absence for the corporate medical staff office.
- Coordinates and prepares all end-of-year medical staff work.
- Researches, analyzes and makes the determination regarding medical staff appointees' ability to perform various acts in the hospital setting.
- Assists in the management of the medical staff support function for the Medical Staff Organization as outlined in the Medical Staff Bylaws.
- Prepares files for review and recommendation by the medical staff.
- Coordinates credentialing end-of-committee process to ensure notification of providers, departments, database and privileging updates; and completion of files as appropriate.
- Schedules, coordinates, prepares agenda, takes minutes, provides follow up for medical staff committees.
- Prepares summary reports of credentialing/privileging recommendations and ensures flow of information and action items for medical staff committees outlined in the Medical Staff Bylaws.
- Interprets federal, state, local, and government/insurance agency regulations and guidelines, as well as University, Medical Staff Bylaws, rules and regulations, policies, and procedures; advises providers, management, and administrators on compliance issues as appropriate.
- Generates queries and reports from credentialing and privileging database.
- Assists with clinical privilege development and maintenance of the privilege database.
- Performs miscellaneous job-related duties as assigned.
Physical Requirements
Performs most work under normal office conditions. Includes sitting for long periods of time, standing, walking, using repetitive wrist and arm motion frequently and lifting boxes of files being transported between facilities. Must use frequent and variable body movements during filing and maintaining records.
Education, Experience and Certifications
- High School Diploma or GED required. Bachelor's Degree preferred. Certified by National Association medical Staff Services or Certified Provider Credentialing Specialists preferred. 3 to 5 years experience preferred.
Preferred Qualities:
- Knowledge of medical staff affairs operational processes.
- Knowledge of medical credentialing and privileging procedures and standards.
- Knowledge of related accreditation and certification requirements (TJC, DNV, CMS).
- Working knowledge of clinical and/or hospital operations and procedures.
- Knowledge of clinical privilege criteria development.
- Knowledge of medical staff policies, regulations, and bylaws and the legal environment within which they operate.
- Information research skills.
- Ability to analyze, interpret, and draw inferences from research findings, and prepare reports.
- Ability to communicate effectively, both orally and in writing with all levels of the organization.
- Ability to use independent judgment and to manage and impart confidential information.
- Knowledge of project management principles, practices, techniques, and tools.
- Database management skills including query and report generation.
- Ability to make administrative/procedural decisions and judgments.
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