Medical Staff Services-Administrative Manager

Olney, MD, United States

General Summary of Position Provides day-to-day management of Medical Staff Services department to ensure compliance with medical staff Bylaws, State, Federal, regulatory agencies.Essential involvement in the discussion, recommendations, and action of the Credentials Committee, Medical Executive Committee, and the Quality Safety PA Committee of the Board. Provides support of the medical staff accreditation readiness and survey process as it relates to The Joint Commission and/or National Committee for Quality Assurance, and Department of Health visits.Ensures the credentialing/privileging process complies with organizational as well as an accrediting agency, Federal, and State regulatory standards. Responsible for the audit and compliance of all credentialing files, which includes management of credentialing information, coordination of facility correspondence, and interaction with practitioners and MSH CVO and MedStar Family Choice associates. Responsible for the management of facility-specific data within the credentialing database.

Primary Duties and Responsibilities Assists in the development of departmental goals, objectives, policies, and procedures. Ensures compliance with business unit policies and procedures and governmental and accreditation regulations.

Selects, trains, orients, and assigns department staff. Works with Director to develop standards of performance, evaluates performance, and conducts performance management planning. Initiates or makes recommendations for personnel actions. Maintains ongoing communication with subordinates to review programs, provide feedback, discuss new developments, and exchange information.

Provides input into the development of departmental operating budget and manages resources according to the approved budget.

Ensures compliance with CMS, TJC, and/or NCQA standards and practitioner credentialing regulations as mandated by State and Federal law.

Responsible for data entry of facility-specific practitioner data within the credentialing databases. Utilizes appropriate database tracking reports to ensure accuracy and thoroughness of imported data as well as data that may be entered manually.

Assists with the billing, collection, and deposit of medical staff.

Coordinates the granting of temporary privileges for medical staff and advanced practice clinicians in accordance with corporate policy and medical staff bylaws.

Manages the initial and reappointment credentialing process at the facility level.Works in collaboration with the MSH CVO associates for timely receipt and accuracy of credentialing and re-credentialing applications. Tracks initial/re-credentialing applications sent, received, and in-process.

Responsible for 100% auditing and analyzing all applications for clarity, quality, and completeness of data in accordance with policies and procedures, Joint Commission, NCQA accrediting standards, and state and federal regulatory requirements.

May process initial/re-credentialing applications for those applications that have been deemed

Processes all applications for modification of privileges.

Works collaboratively with the Director, AVP, VPMA, legal, and medical staff leadership to develop, revise and implement policies, procedures, and documents related to credentialing, privileging, and medical staff services.

Assists the Director with the preparation of correspondence and periodic reports on a variety of matters requiring an in-depth understanding of departmental needs and activities for medical staff leadership, hospital leadership, and departmental meetings in matters relating to medical staff services, credentialing, privileging, practitioner professional practice evaluation/quality profiles and primary source verification.Includes the data collection for FPPE/OPPE.

Actively participates in activities to support the functions of the organized medical staff, including but not limited to the Credentials Committee, Medical Executive Committee, and Medical Staff meetings.

Maintains competency on nationally recognized medical staff services and credentialing-related initiatives through participation with NAMSS and MAMSS, journal articles, and other industry-related news.

Maintains competency on the credentialing database via participation in online education learning modules and monthly skills-related webinars.

Participates in meetings and on committees and represents the department and hospital in community outreach efforts.

Participates in multi-disciplinary quality and service improvement teams and maintains effective working relationships with other departments.

Minimum Qualifications

Education Bachelor's degree in related fieldrequired

Experience 3-4 years Experience in credentialing and/or medical staff services management. Equivalent experience in areas related to regulatory, quality, risk management and compliance will be also be considered.

Licenses and Certifications Certified Provider Credentialing Specialist (CPCS)within 1 Year required or

CPMSM - Certified Professional Medical Services Managementwithin 1 Year or

Other related certification, such as Certified Professional Healthcare Quality (CPHQ), Registered Health Information Administrator (RHIA), Certified Professional in Healthcare Risk Management (CPHRM), or Certified Professional Compliance Office (CPCO) may be considered equivalent upon initial hire.

Knowledge, Skills, and Abilities Proven problem-solving skills and ability to exercise independent judgment.

Business acumen and leadership skills.

Strong verbal and written communication skills with the ability to effectively interact with all levels of management, internal departments, and external agencies.

Working knowledge of various computer software applications.

Why MedStar Health?

At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through: Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.

Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities.We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.

Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.

More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.

About MedStar Health

MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.