Medical Staff Services Specialist

2 weeks ago

Toledo, United States ProMedica Full time

Facilitates medical staff administrative and credentialing functions for the medical staff and medical staff leadership. Provides guidance, support and management to the medical staff leadership. Carries out this responsibility under the direct supervision of the Director, Medical Staff Services.

ACCOUNTABILITIES

* All duties listed below are essential unless noted otherwise*

Credentialing/Privileging

* Facilitates the credentialing and privileging functions for specific clinical departments (medical staff membership and allied health professionals). This includes the verification process (including primary source verification for medical school, internship, residency, fellowship, medical references, databank, malpractice insurance coverage and claims history, state medical boards and board certification) for initial appointments. Identification of "red flags" (time gaps, discrepancies, derogatory information, etc.) through analyzation of primary source verifications with appropriate follow-up and consultation with medical staff leadership.
* Analyze & process credentialing requests for additional privileges, change of status and temporary & interim privileges.
* Independent review of reappointment process to include: interpretation and analyzation of quality assessment activities, initiation of appropriate information gathering, and follow up with medical staff leadership. Responsible for ensuring reappointment process in compliance with medical staff, state and federal requirements
* Compiles data and develops various reports for medical staff leadership and administrative staff to include joint credentials committee, medical executive committee, and Board of Trustees.

Medical Staff Leadership/Administrative Resource

* Interfaces directly with the medical staff, medical staff officers, section heads, special review physicians, committee & department chairs, as well as administration and hospital staff.
* Yearly orientation/training of newly elected medical staff leadership to specific functions/responsibilities that include: credentialing, privileging, corrective action, federal & state laws (NCQA/JCAHO standards, Health Care Quality Improvement Act, HCFA), quality improvement activities and departmental issues.
* Serves as a professional liaison between medical staff and hospital departments

Practitioner Performance Monitoring

* Review, analyze and communicate ongoing provider practice evaluation/ focus provider practice evaluation data
* Review and facilitate to resolution reported unprofessional/disruptive behavior issues related to medical staff
* Facilitation of Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) processes across all credentialed practitioners and providers.

Department/Committee Facilitation

* Provides expertise, leadership and direction to assigned medical staff departments, sections and committees including research of medical staff issues, preparation of correspondence and special reports; development and coordination of the observation and supervision/proctorship policies, and gathering of necessary documentation, as specified by each department.

Organizational/Regulatory Compliance (TJC/HIPAA, Peer Review, etc)

* Requires high level of expertise and interpretation and application of medical staff bylaws, JCAHO standards, NCQA standards, state and federal regulations relative to medical staff organization, hospital organizational structure and credentialing/privileging.

Job Requirements

Education: Must have a bachelors degree (or actively involved in completion process) in a health or business related field.

Skills: Proficiency with MS Outlook, MS Teams, Word, Excel, and PowerPoint.

* Requires initiative, organization ability, strong interpersonal communication skills and problem solving/analytical skills/critical thinking skills.
* Demonstrated knowledge of The Joint Commission, NCQA, Federal, and State requirements regarding the credentialing process.
* Ability to gather and coordinate required information under strict timeliness is required.
* Ability to pay close attention to detail is required to comply with credentialing requirements.
* Highly effective verbal communication, presentation skills, and writing skills are necessary in order to work with medical and clinical staff.
* Ability to prioritize workload.
* MUST BE ABLE TO MAINTAIN CONFIDENTIALITY.

Years of Experience: 3 years experience in the healthcare setting

PREFERRED QUALIFICATIONS

Years of Experience: 3-5 years of preferred experience in medical staff services or credentialing. Certification by the National Association of Medical Staff Services (NAMSS) preferred. Knowledge of medical terminology.

Certification: CPCS or CPMSM certification preferred

WORKING CONDITIONS

Physical Demands: must be able to lift 50 pounds.

ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org

Equal Opportunity Employer/Drug-Free Workplace

Employee Exemption Type

Non-Exempt

Job Type

Full Time

Budgeted Hours / Pay Period

80

Shift Type

Days

Shift Hours

8 hours

Weekends

On-call Requirements

Additional Schedule Details

  • Medical Staff Services Specialist

    1 week ago

    Toledo, United States ProMedica Health System Full time

    Facilitates medical staff administrative and credentialing functions for the medical staff and medical staff leadership. Provides guidance, support and management to the medical staff leadership. Carries out this responsibility under the direct supervision of the Director, Medical Staff Services. ACCOUNTABILITIES *All duties listed below are essential...

  • Medical Laboratory Specialist

    1 week ago

    Toledo, Ohio, United States OneStaff Medical Full time

    We are seeking a skilled Medical Laboratory Specialist to join our team in Toledo, Ohio. As a Medical Laboratory Specialist, you will be responsible for examining specimens using microscopes to evaluate specimen quality and detect abnormal hormone conditions.About the RoleThe ideal candidate will have strong analytical skills and attention to detail, with...

  • Medical Imaging Specialist

    3 weeks ago

    Toledo, Ohio, United States Titan Medical Full time

    About the RoleWe are seeking a skilled Medical Imaging Specialist to join our team for a 13-week travel assignment in Ohio. As a Special Procedures/Angio/IR Tech, you will be responsible for providing high-quality imaging services and collaborating with healthcare professionals to ensure exceptional patient care.

  • Medical Donor Screener Specialist

    3 weeks ago

    Toledo, Ohio, United States CSL Plasma Full time

    Job Title: Medical Donor Screener SpecialistEstimated Salary: $60,000 - $80,000 per year.We are seeking a highly skilled Medical Donor Screener Specialist to join our team at CSL Plasma. In this role, you will be responsible for greeting donors at the plasma collection center and conducting a series of registration procedures to qualify donors for the plasma...

  • Environmental Services Specialist

    1 week ago

    Toledo, Ohio, United States ProMedica Health System Full time

    **About Us**At ProMedica Health System, we are committed to delivering exceptional patient care and creating a safe and clean environment for our patients. We are seeking a highly motivated and detail-oriented individual to join our team as an Environmental Services Specialist.We offer a competitive salary of $40,000 per year, plus benefits and opportunities...

  • Mobile Medical Laboratory Specialist

    2 weeks ago

    Toledo, Ohio, United States OneStaff Medical Full time

    OneStaff Medical is seeking a highly skilled Mobile Medical Laboratory Specialist to join their team in Toledo, Ohio.About the Job:This 13-week assignment offers the opportunity to work as a Cytotechnologist, examining specimens using microscopes to evaluate specimen quality and detect abnormal hormone conditions.As a Mobile Medical Laboratory Specialist,...

  • PAR - Medical Coding Compliance Specialist

    4 weeks ago

    Toledo, United States Medical Mutual of Ohio Full time

    Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and MA (Medicare Advantage) with assigning and maintaining diagnoses medical codes. Evaluates requests for adherence to Company policies for t Compliance Specialist, Medical, Specialist, Compliance, Clinical, Insurance, Healthcare, Risk Learn More

  • Medical Director

    3 weeks ago

    Toledo, Ohio, United States DOCTORS CHOICE PLACEMENT SERVICES, INC. Full time

    About the PositionWe are seeking a highly skilled Surgical Pathology Specialist to join our team at Doctors Choice Placement Services, Inc. in Metro Northwest Ohio.

  • Medical Record Specialist

    3 weeks ago

    Toledo, Ohio, United States State of Ohio Full time

    **Job Title:** Medical Record Specialist - Psychiatric/MR Unit**Estimated Salary:** $55,000 per year About Us:The State of Ohio is committed to providing quality healthcare services to its citizens. We take pride in our team of dedicated professionals who work tirelessly to deliver exceptional care. Job Summary:We are seeking a skilled and compassionate...

  • PAR - Medical Coding Compliance Specialist

    3 weeks ago

    Toledo, United States Medical Mutual of Ohio Full time

    PAR - Medical Coding Compliance Specialist - (2400594) Job Summary: Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and MA (Medicare Advantage) with assigning and maintaining diagnoses medical codes. Evaluates requests for adherence to Company policies for the most precise medical codes....

  • PAR - Medical Coding Compliance Specialist

    3 weeks ago

    Toledo, United States Medical Mutual of Ohio Full time

    PAR - Medical Coding Compliance Specialist - (2400594) Job Summary: Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and MA (Medicare Advantage) with assigning and maintaining diagnoses medical codes. Evaluates requests for adherence to Company policies for the most precise medical codes....

  • Client Services Support Specialist II

    3 weeks ago

    Toledo, United States Nemsys Full time

    Client Services Support Specialist II Toledo, OH Nemsys LLC is currently searching for a Client Services Support Specialist II to join their team in Toledo, Ohio! The IT Client Support Specialist II is a more experienced role responsible for providing second-level technical support and mentorship to junior support staff. The ideal candidate will have a...

  • Client Services Support Specialist II

    3 weeks ago

    Toledo, United States Nemsys Full time

    Client Services Support Specialist II Toledo, OH Nemsys LLC is currently searching for a Client Services Support Specialist II to join their team in Toledo, Ohio! The IT Client Support Specialist II is a more experienced role responsible for providing second-level technical support and mentorship to junior support staff. The ideal candidate will have a...

  • Client Services Support Specialist II

    6 days ago

    Toledo, United States Nemsys Full time

    Client Services Support Specialist II Toledo, OH Nemsys LLC is currently searching for a Client Services Support Specialist II to join their team in Toledo, Ohio! The IT Client Support Specialist II is a more experienced role responsible for providing second-level technical support and mentorship to junior support staff. The ideal candidate will have a...

  • Pupil Services Nurse Specialist

    3 weeks ago

    Toledo, Ohio, United States Toledo Public Schools Full time

    About the RoleIn this exciting opportunity, you will have the chance to make a real difference in the lives of students in Toledo Public Schools. As a Pupil Services Nurse Specialist, you will work closely with teachers, administrators, and other support staff to identify and address the healthcare needs of students.The successful candidate will possess a...

  • PAR - Membership Services Specialist I

    4 weeks ago

    Toledo, United States Medical Mutual Full time

    Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare...

  • Medical Care Specialist

    2 weeks ago

    Toledo, Ohio, United States Franciscan Care Center Full time

    Job Title: Medical Care SpecialistWe are seeking a dedicated and compassionate Medical Care Specialist to join our team at Franciscan Care Center. As an LPN or RN, you will play a vital role in delivering exceptional care to our residents.About UsFranciscan Care Center is a leading provider of residential and rehabilitation services inspired by the rich...

  • Bar Service Specialist

    1 week ago

    Toledo, Ohio, United States Packo's at the Park Full time

    Packo's at the Park seeks a highly skilled Bar Service Specialist to join our team. As a key member of our bar staff, you will be responsible for providing exceptional customer service and ensuring a seamless experience for all patrons.Job Summary:The ideal candidate will have a passion for mixology and a keen eye for detail. You will work closely with...

  • Medical Care Specialist

    1 week ago

    Toledo, Ohio, United States ProMedica Full time

    About the RoleProMedica is seeking a skilled Medical Care Specialist to join our team in Toledo, OH. This is a full-time position with 80 budgeted hours per pay period.Job SummaryWe are looking for a dedicated and compassionate individual to provide exceptional patient care services in a fast-paced environment. As a Medical Care Specialist, you will be...

  • Service Support Specialist

    1 week ago

    Toledo, Toledo, United States Twin Peaks Full time

    OverviewTwin Peaks, a renowned establishment in the Civic Centre area, is seeking an exceptional individual to join our team as a Service Support Specialist. This dynamic role offers a unique opportunity to contribute to the success of our dining experience.About the RoleAs a key member of our team, you will be responsible for ensuring the cleanliness and...