Monitor for compliance with regulatory and accreditation standards as applicable for medical staff and credentialing and privileging functions
Participate on hospital compliance teams and in regulatory/accreditation surveys as applicable
Oversees the departmental operations, assuring the delivery of superior credentialing verification services and privileging for all hospital entities, their medical staffs, and any contracted clients.
Oversees medical staff credentialing while enforcing MSSD policies and procedures as applicable
Provides Strategic leadership to the Credentialing Verification Organization (CVO) and Medical Staff Office (MSO) and Provider Enrollment (PE).
Provides oversight for credentialing and provider enrollment and medical staff functions for all employed providers, and assures timely enrollment of all facilities and medical groups with payers.
Manage and support the leadership meetings of the organized medical staff
Participate in and collaborate on medical staff and hospital committees as applicable
Collaborate with the quality department to fulfill requirements of established performance monitoring processes (e.g., focused and ongoing professional practice evaluation)
Support and/or assist in implementing and maintaining credentialing software(CACTUS) as applicable
Review and refine MSSD departmental policies and procedures as applicable
Knowledge, Skills and Ability Requirements:
• Understands provider enrollment credentialing and privileging processes for hospitals and ambulatory care settings • Computer Proficiency, Microsoft Office to include Word, Excel, Power Point • Ability to work with multiple application specific databases • Advanced knowledge of medical terminology • Excellent interpersonal skills and customer service orientation • Ability to work within and promote a team environment • Attention to detail • Ability to work with multiple projects and deadlines and to support medical staff leaders and functions. • Strong analytical skills • Expert knowledge of JC and NCQA standards, as well as federal and state regulations with regard to medical staff credentialing • Ability to coach and mentor staff • Excellent written and verbal communication skills and organizational ability • Possesses strong management skills. • Experience with database management • Foundational experience in quality improvement approaches such as LEAN
Internal Number: 1001
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