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Corporate Medical Staff Credentialing and Privileging Manager

4 months ago


Franklin, United States Community Health System Full time

Job Description

Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Summary:

The Medical Staff Credentialing and Privileging Manager oversees medical staff credentialing services conducted throughout the Enterprise, under the direction of the Corporate Director of Medical Staff Credentialing and Privileging. The Manager is responsible for the completion of projects as assigned to ensure the highest standards of healthcare quality, safety, and compliance. This position requires strategic thinking, excellent communication skills, and a deep understanding of regulatory requirements related to medical staff credentialing and privileging.

Essential Duties and Responsibilities:

* Strategic Planning:
* Participates in departmental strategic planning to align with organizational goals and industry standards for medical staff credentialing and privileging.
* Plan, implement, execute, and evaluate special projects.


* Leadership:
* Effective communication with corporate vendors that provide software and technology to support hospital medical staff credentialing and privileging.
* Works collaboratively with hospital credentialing and privileging personnel to facilitate a standardized credentialing and privileging process.
* Is organized, accountable, and has effective time management skills.
* Participates in the roll out of tactical action plans, individual goals and accountability measures that result in successful execution of organization goals.
* Is fiscally responsible for company assets and resources.


* Regulatory Compliance: Stays abreast of changes in healthcare laws and regulations to ensure continuous compliance.
* Technology Integration: Able to implement and optimize credentialing and privileging and associated electronic and cloud-based technology, ensuring seamless integration. Super user of medical staff credentialing and privileging software.
* Policy Development and Compliance: Assists in the development of standardized policies and procedures for credentialing and privileging that comply with state, federal and accrediting body regulations for the Enterprise.
* Reporting: Reports all important matters to the Corporate Director of Medical Staff Credentialing and Privileging in a timely and clear manner when issues arise to avoid unnecessary surprises.
* Privileging Management: Maintains privileging criteria for various provider / practitioner roles; reviews and assists with updating privileging criteria based on changes in industry standards, evidence-based practices, and regulatory requirements.
* Performance Monitoring and Reporting: Understand the key performance indicators for credentialing and privileging processes and regularly evaluate the performance against goal metrics. Presents reports to the Director regarding the status of credentialing and privileging activities.
* Continuous Improvement: Identifies opportunities for process improvement and efficiency in the credentialing and privileging workflow; analyze data and metrics to identify areas for improvement; and assists with implementation of best practices and innovative solutions to enhance the overall effectiveness of the department and its processes.
* Collaboration: Collaborate with all other affected and relevant departments / teams to address any issues related to medical staff credentialing and privileging.
* Training, Education and Support: Provides and training of new medical staff professionals and hospital quality leaders involved in the medical staff credentialing and privileging processes. Provides resources to MSO leaders to assist them in carrying out their responsibilities.
* Personal Accountability: Manages daily operations with accountability for achieving targeted levels of growth and additional specified short- and long-term objectives. Accountable for ensuring sound commitments on behalf of the organization, including clear scope of work, appropriate risk assessment and adherence to reasonable business practices and organization standards.
* Other duties as assigned.

Qualifications:

* Required Education: Associate degree in business or healthcare-Related Discipline
* Preferred Education: Bachelor's degree in business or healthcare-Related Discipline
* Required Experience: Minimum of 3-5 years of hospital-based medical staff credentialing and privileging.
* Preferred Experience: Previous management leadership role in medical staff credentialing and privileging. Knowledge of MD-Staff.
* Required License/Registration/Certification: None
* Preferred License/Registration/Certification: Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) - OR has comparable experience and obtains certification within 24 hours following hire date.
* Computer Skills Required: Microsoft office products [Word, Excel, and Power Point], medical staff credentialing and privileging software [MD-Staff], Google workspace products [Drive, Meet, Doc, Sheet, Slides, Calendar, Email].

Physical Demands:

In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:

* The Employee is required to read, review, prepare and analyze written data and figures, using a PC or similar, and should possess visual acuity.
* The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
* The Employee is not substantially exposed to adverse environmental conditions and therefore, job functions are typically performed under conditions such as those found within general office or administrative work.
* The employee may be required to travel, which would require traveling short or long distances, and lifting up to 50 pounds.