Supervisory Health System Specialist

Found in: beBee jobs US - 2 weeks ago

Cincinnati, Ohio, United States Department Of Veterans Affairs Full time
Summary

The Cincinnati, OH VA Medical Center (VAMC) is recruiting for a Supervisory Health Systems Specialist (Credentialing and Privileging Manager). The person selected for this position will need to possess specialized and extensive experience in credentialing and privileging within the VA, along with supervisory experience. This position is assigned to the Medical Staff Office, which is reports to under the Chief of Staff (COS).



Duties

The supervisor in this position:

  • Oversees functions related to healthcare providers' professional credentials supporting the divisions of CVAMC in accordance with VHA Credentialing and Privileging (C&P), Directives, VA Handbooks, Policies, Memos, and Notices; The Joint Commission (TJC) Standards and State and Federal Regulations.
  • Works collaboratively with local and VISN leadership to identify and/or implement best practices.
  • Ensures quality assurance and provides oversight for the C&P program.
  • Ensures Medical Staff Bylaws/Rules and Regulations are reviewed and updated as needed to reflect regulations or accreditation standards.
  • Serves as Senior Technical Advisor/primary consultant/liaison to VISN C&P Office.
Duties include but are not limited to:

Supervisory: provides direct technical and administrative supervision to employees in the CVAMC's C&P Office. Responsible for ensuring employees are efficiently and effectively accomplishing quality work, which is compliant with regulatory requirements and procedures, TJC standards, laws, and VHA C&P policies and requirements. Assures implementation and accomplishment of goals and objectives of the C&P Program. The supervisor outlines C&P program goals and objectives, identifies risks, supervises C&P employees, ensures training/education, and completes 2nd level reviews.

Senior Program Advisor: Provides consulting and guidance to local leadership and C&P employees on matters pertaining to the facility's C&P program including Healthcare Professionals' C&P; facility Scope of Practices; National and VISN Memorandums of Understanding; Veterans' Administration Memorandums; VHA requirements, Handbooks, Directives and Policies; TJC Standards; quality assurance assessments; risk management and malpractice claim action evaluations. Determines appropriate actions, including those resulting from VISN and local level reviews, initial and re-credentialing processes, including, but not limited to primary source verifications; reporting and data trends, identified issues that require further review, and electronic credentialing database and clinical privilege maintenance. Supervisor attends committee meetings and presents providers' credentials, clinical practice histories and red flags; documents and composes committee minutes, privileging requests and/or actions, malpractice payments, tort claims and adverse actions, Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) reviews and completion timeframes. Is the POC/SME for all Human Resources matters, ensuring C&P requirements are completed on providers prior to patient care activity; State Licensing Board Reporting; electronic credentialing database actions and training; VETPro quarterly access reports; Our Providers quarterly certifications; provider and credentialer VETPro accounts.

Quality Assurance: Responsible for ensuring quality assurance in the facility's C&P program. This involves applying organizational and system-wide strategies for continuous quality improvement as they relate to C&P processes and procedures. Implements mechanisms to monitor and evaluate completed tasks for their compliance with established policies and procedures as well as quality of customer service. Participates in policy and decision-making initiatives at the VAMC, and continuously develops a greater understanding of regulatory and policy requirements, quality assurance methodologies as well as best practices. Conducts supervisory reviews of completed tasks, present information, and make recommendations on how to improve. Utilizes evaluation results to make suggestions and improve organization/program performance. Uses cost-effectiveness, cost-benefit, and cost-utility analyses in programmatic prioritization and decision making. Performs internal reviews and audits of current systems and policies. Performs quality assurance checks.

Program Account Administrator: Serves as the administrator for the TRJC. This involves managing enrollments, single queries and re-enrollments; preparing and submitting reports for adverse privileging actions; submitting federal tort claims for substandard clinical care per the Office of General Counsel; ensuring primary source verification is obtained and processed via quality control review. Serves as the administrator for the Federation of Medical Boards and acts as the administrator for the Our Providers Database.

Performs other C&P program related duties as assigned.

Work Schedule: 7:30am to 4:00pm

Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process.

Virtual: This is not a virtual position.

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