Medical Services Corps

AJANTA CONSULTING

St. Louis, MO

The Medical Service Corps (MSC) Administrator shall oversee the day-to-day Credentialing and Privileging (C&P) program operations encompassing all aspects of inpatient, emergency and/or ambulatory care and support functions within the Saint Louis Medical Military-Civilian Partnership (STL-MCP) through USAFSAM/711th HPW via the Office of Military Medicine (OMM), which oversees clinical rotations by military medical personnel from multiple units at non-military hospitals in Eastern Missouri and Southern Illinois.

Responsibilities

• Serves as the authority for Air Force Medical Service (AFMS) C&P matters for the Office of Military Medicine (OMM). The Office of Military Medicine is the office with responsibility for one of the largest military-civilian medical collaborations in the US, created to maximize military medical activities at civilian hospitals with a focus on collaboration and readiness.
• Serves as primary interface between the OMM Director, his/her executive staff, medical staff members, legal consultants, military medical units, CHCOs and other agencies [e.g., civilian, Air Force (AF), Army, Navy, Reserve, Guard, Veterans Affairs (VA)] regarding credentials, privileging and certification issues.
• As the OMM C&P subject matter expert the position interprets general regulations, instructions, rules, and local policies and ensures operations are in line with regulatory and mission requirements. Provides authoritative technical advice to the OMM, military medical units, CHCOs and other professional staff members regarding medical staff credentialing, privileging, and professional certification programs.
• Coordinates and ensures proper collaboration between all agencies participating in the OMM program ensuring that all C&P documentation for military members (privileged and non-privileged providers, nurses and technicians from multiple specialties) from all organizations represented is complete and accurate; allowing them to conduct training at CHCOs in specialized hospital sections such as; trauma, emergency room, burn and inpatient units, intensive care, obstetrics/gynecological, general medical/surgical floors, pediatrics, etc.
• Manages initial, annual, biennial, and other privileging actions of healthcare providers to ensure short- and long-range plans for implementation for mission success and all regulatory requirements are met.
• Researches, clarifies, analyzes, and applies accrediting agency standards, DoD, AF, and CHCO regulatory policies and guidance. Interprets and incorporates pertinent C&P directives and policy guidelines from higher authorities into OMM policy for approval by the OMM Director and Board of Directors. Interprets regulatory guidance to ensure USAFSAM personnel and rotators and CHCOs provide the highest quality medical care possible to achieve/maintain mandated accreditation.
• Develops new office processes and business procedures to improve OMM program objectives and operations. Coordinates office workload and provides overall support to staff on a wide range of administrative processes.
• Prepares for surveys/inspections and may serve as an internal resource and liaison to accrediting/inspection agencies. Prepares and presents command, director and/or Chiefs of Staff-level briefings necessary for the orderly function of the C&P program.
• Advises health care providers of medical staff by-laws, rules, regulations, and criteria required for requests for and delineation of clinical privileges for the provision of patient care.
• Produces C&P reports for leadership and executive staff of USAFSAM, OMM Board of Directors, and CHCOs for use in making performance-based decisions about the organization. Prepares and presents orientations, formal presentations, and training to the executives, medical professional staff members, and support staff members of the OMM and CHCOs to educate them on the C&P criteria ensuring mission requirements are met.
• Administers and maintains all documentation for privileged and non-privileged rotators/trainees, in support of an AFMS training platform, while ensuring that medical military staff comply with any health/safety requirements and/or trainings set forth by The Joint Commission, CHCOs, SLUSOM, and/or WashUSOM.
• Completes and audits documentation to determine accuracy of onboarding process and records. Introduces rotators/trainees to key personnel and schedules their initial training and orientation requirements. Keeps senior management informed of program progress and advises of any significant developments that may impact operations.
• Coordinates and collaborates with other departments within the OMM, USAFSAM, Defense Health Agency (DHA) and Air Force Medical Readiness Agency (AFMRA) to verify adherence to Department of the Air Force Instructions (DAFIs), DoD Instructions and Manuals, Defense Health Agency (DHA) Memorandum of Medical Quality Assurance and Clinical Quality Management in the Military Health System (MHS) in support of patient safety related to accreditation and compliance programs.
• Utilizes various databases, software programs and automated data systems, including but not limited to, Electronic Health Care Records Systems [i.e., Epic, Composite Health Care System (CHCS) and Armed Forces Health Longitudinal Technology Application (AHLTA) or Genesis], health care monitoring tools/applications (e.g., Carepoint), and other related programs. Uses Joint Centralized Credentials Quality Assurance System (JCCQAS) in the collection, tracking, and reporting of required data by military Credentialing, Privileging and Risk Management Offices on Health Care Practitioners within their facilities and for readiness and humanitarian missions.
• Assists with updating and reviewing annually the Training Affiliation Agreements (TAAs) and Memoranda of Agreement (MOAs & MOUs) with all civilian universities/military organizations, which require significant coordination with each legal division(s) and the United States Air Force.
• Plans, organizes, and oversees tactical aspects of the C&P program regarding military medical providers rotating through CHCOs and affiliates to ensure timely, high quality health care which is essential to sustaining clinical currency and medical readiness skills for permanent and rotating privileged providers.
• Assists with on-boarding at CHCO facilities and ensures provider profiles are created in the Electronic Health Record System, allotting appropriate order entry and access for providers.
• Perform the following administrative management service-oriented tasks: answering the office phones, typing, filing, building and maintaining simple databases, ordering office supplies, constructing training and in processing packets for all rotators.
• Obtains, Primary Source Verifies, and monitors all required credentials. Performs all additional required queries. Analyzes and evaluates the credentials processes in meeting established goals and objectives set by the Medical Staff Managers at participating CHCOs.
• Effectively communicates with the Commanders and Department Heads to ensure essential data is accessible for the award of privileges, appointment, and re-appointment of providers to the medical staff.
• Works closely with the commanders and department chairman as they interrelate to the credentials process and accurately provide pertinent provider information and feedback. Provides ongoing updates/changes of the C&P processes.
• Remains current in all aspects of accreditation, DoD, and Air Force Medical Service (AFMS) credentialing standards to ensure compliance by the participating facilities.
• As OMM authorized agent and certifying official, queries and processes confidential information concerning provider’s credentials from numerous national data banks and registration entities. Responsible for security of the provider’s credentials and activity files.
• Initiates applications for fee-exempt Drug Enforcement Administration (DEA) registration and primary point of contact for Provider Enrollment Change and Ownership System (PECOS) as needed. Ensures Criminal History Background Checks in regard to C&P are conducted in accordance with guidance of AF, DHA, and CHCOs on designated applicants.
• Analyzes background information used in establishing competence of medical, dental and allied health care professionals. Verifies that applicant professional credentials comply with DoD, AFMS, and CHCO accrediting agencies’ C&P policies and regulatory entities ensuring the safety of the patients.
• Provides advice and guidance to the OMM and CHCOs’ Credentials Function regarding a provider’s ability to clinically practice and perform requested procedures. Provides credentials guidance, ensures adherence to credentials requirements, eligibility criteria for the position and award of clinical privileges.
• Manages the credentials (i.e., training, licensure, certification, and/or registration) of health care personnel, tracks expiration dates and provides notifications prior to the deadlines, and initiates timely and appropriate actions regarding deficient provider credentials.
• Obtains continuing medical education and continuing health care education and validates training of providers requesting delineated medical privileges for appropriateness, continuity, and authenticity to ensure complete compliance with all credentialing policies for the OMM and CHCOs.
• Develops data management tools to ensure essential clinical performance assessment/improvement data is accurately presented and available to all personnel involved in initial award or renewal of privileges and appointment to the medical staff.
• Monitors and reports the status of peer review, Ongoing and Focused Professional Practice Evaluations for timely submissions. Monitors adverse trends to facilitate safe, reliable, quality healthcare and submits a report for review by the OMM and CHCOs’ Chief of the Medical Staff as well as the USAFSAM leadership.
• Ensures completion of all aspects of the reappointment of members of the medical staff and advises the OMM and CHCOs on these issues.
• Monitors for compliance due-process procedures and timelines for professional staff adverse action/impaired provider situations. Provides C&P guidance on all adverse action/impaired provider matters for privileged and non- privileged provider staff per regulatory guidelines and due process procedures.
• Coordinates with health care providers regarding matters of a sensitive nature, interacts with practitioners undergoing disciplinary actions or those identified as impaired providers when required.
• Analyzes significant data relative to providers’ performance to track adverse trends/ incidents. Maintains evidence, documents and communications related to actual ligation, investigation, and/or privileging actions affecting health care providers if required.
• Other duties as assigned.

Qualifications

• Bachelor's degree in business, management, or a health-related field, Master's degree in business, management, or a health-related field, preferred.
• Minimum two (2) years of experience.
• Certification in Certified Professional Credentials Specialist and/or Certified Professional Medical Services Management, preferred.

Knowledge, Skills and Abilities

• Excellent interpersonal skills are required to serve as a liaison between multiple military and civilian medical partnerships. Excellent writing and verbal communication skills are required.
• Proficiency with word processing software, spreadsheet software, and SharePoint applications is required.
• Knowledge and understanding of applicable Air Force and professional standards is mandatory.
• Knowledge of military and civilian guidelines that govern policy and procedure, successful completion of USAFSAM's and Department's orientation programs is required.
• Knowledge of federal and civilian accrediting agency standards, state/national requirements and other regulatory agency requirements regarding licensing and certification, and legislation and laws pertaining to health care delivery systems.
• Knowledge of credentialing and privileging functions, theories, and techniques, executive orders, regulations, policies, and concepts that pertains to credentialing and privileging management. Knowledge of and skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of Credentialing and Privileging Program operations.
• Knowledge applicable to a wide range of health care administration and management functions to include pertinent laws, regulations, policies and precedents which affect the use of program and related support resources.
• Knowledge of medical terminology and procedures sufficient to oversee appropriateness of privileges requested, to interpret and identify discrepancies, and facilitate interaction with medical professional at all levels of the organization, DHA, AFMS, and CHCOs
• Extensive knowledge of Inspection standards and guidelines, Title IV of Public Law 99-660, DoD regulations and directives, Accreditation Standards (i.e., TJC), and state laws pertaining to medical staff issues and their impact on the facility’s credentialing and privileging policies, procedures, and programs in order to evaluate compliance with Air Force, governmental, and private health inspection agency policies and guidelines, advise the military commanders, OMM Board of Directors, military and/or civilian Chiefs of Staff, and/or civilian organizations’ Chief Executive Officers on program deficiencies and provide recommendations for implementation of corrective actions.
• Knowledge of procedures of the National Practitioner Data Bank (NPDB), Federation of State Medical Boards (FSMB), Drug Enforcement Administration (DEA) as relates to the issuance and maintenance of health care provider DEA licensure, Provider Enrollment, Chain and Ownership System (PECOS), the Health Insurance Portability and Accountability Act (HIPAA) as it relates to Protected Health Information (PHI) and state and local regulatory agencies in order to safeguard patient safety and confidentiality during provision of care by all healthcare providers rotating through the CHCOs and maintain verification and continuity of licensure, certification, and adverse reporting for clinicians.
• Expert knowledge of credentials and privileges management as well as program inter-relationships with quality assurance, performance improvement/risk management, organizational structures, and mission requirements and objectives of the DHA, Air Force Medical Service (AFMS), and CHCOs to evaluate suboptimal clinician practice trends.
• Knowledge of and ability to effectively use automated data systems (e.g., JCCQAS, Carepoint, and EHR systems (Epic)) to measure the effectiveness, efficiency, and productivity of the healthcare delivery system and make recommendations to resolve problems.
• Knowledge of analytical processes and tools sufficient to research and identify complex problems or unusual situations regarding quality improvement and the credentials and privileging process within CHCOs.
• Knowledge and ability to apply executive orders, regulations, policies and concepts pertaining to credentials and privileging management to analyze, evaluate and upgrade specialty-specific credentialing requirements and privileging lists, including skill in explaining and defending recommendations.
• Knowledge of health care directives related to legal practices and their association to adverse privileging actions.
• Skill in organization and communication to develop working relationships and administer programs with diverse military, civilian, professional, and technical populations, to include verbal and writing skills to prepare presentations and/or briefings.
• Knowledge and skill in applying analytical an evaluative methods and techniques sufficient to identify problems or unusual situations regarding administrative issues Preferred.
• Skill in developing interpersonal relationships, maintaining good working relationships, and working cooperatively as a liaison between various military organizations and civilian medical facilities Preferred.
• Skill and ability to collect and analyze program data and report results of continuous monitoring activities for use in organizational decision-making Preferred.
• Ability to build Word documents, spreadsheets using Excel Program, and presentations using PowerPoint.

Physical Demands: (The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

• While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee may use repeated motions that include the arms, wrists, hands and/or fingers. The employee is occasionally required to walk, stand, climb, balance, stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.

Any estimated salary provided by this job board may not align with Chenega's compensation program. Please apply to connect with a recruiter who can provide more details.

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Our wide range of benefit options is designed to support and protect employees and their families. Based on eligibility, benefits include medical, dental, vision, prescription plans, wellness programs, income protection, paid leave, and retirement. Positions covered by the McNamara-O'Hara Service Contract Act, Davis-Bacon Act, or a Collective Bargaining Agreement (CBA) will comply with the statute or CBA requirements.

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