Director of Medical Staff Credentialing

Universal Health Services•Bradenton, FL

76d

About The Position

The Director of Medical Staff Credentialing provides strategic leadership and oversight for all aspects of medical staff credentialing, privileging, and reappointment processes. This position ensures compliance will all regulatory, accreditation, and hospital bylaws requirements while maintaining efficient, accurate, and timely credentialing. The Director serves as the key liaison between hospital administration, the medical staff, and external regulatory agencies to support high standards of clinical quality, patient safety, and professional accountability. Always demonstrates Service Excellence. Other duties as assigned.

Requirements

Excellent written and verbal communication skills
Computer skills required (Word, Excel, PowerPoint, Outlook).
Customer service skills required.
Understanding of credentialing and re-credentialing functions. The Joint Commission, State and Federal Regulatory Requirements, and overall knowledge of an organized Medical Staff required.
Bachelor's degree in healthcare or business administration is required, or 10+ years of relevant experience may be considered.
Minimum of five years of medical staff credentialing experience required.
CPCS or CPMSM Certification or actively pursuing certification through NAMSS
Knowledge of credentialing software database, preferably MD-Staff.

Nice To Haves

Master's degree in health or business administration and/or certification by the American College of Medical Practice Executives is preferred.

Responsibilities

Lead and manage the Medical Staff Services Department, including credentialing specialists and support staff.
Oversee all credentialing, privileging, reappointment, and peer review functions for medical staff, allied health professionals, and contract providers.
Ensure adherence to hospital bylaws, Joint Commission (TJC), CMS, and state regulatory standards.
Serve as a trusted advisor to the CEO, CMO, and Medical Executive Committee on credentialing and privileging matters.
Direct and maintain a comprehensive credentialing and privileging database, ensuring accuracy, confidentiality, and timely updates.
Oversee initial and reappointment application processing, primary source verification, and ongoing monitoring of practitioner credentials.
Coordinate with medical staff leadership to review and update privileging criteria and processes.
Develop and maintain policies, procedures, and workflows to support efficient credentialing operations.
Maintains current master copy of the Medical Staff Bylaws, Rules and Regulations, and Credentials Manual and has a working knowledge of such.
Serve as the liaison between hospital administration, department chairs, and medical staff committees.
Facilitate communication between the medical staff and hospital leadership regarding credentialing, privileging, and peer review issues.
Support medical staff governance functions, including coordination of Medical Executive Committee and Credentials Committee activities.
Prepares monthly meeting Medical Staff calendar.
Prepares monthly ER call schedules for multiple specialties.
Coordinates physician and Allied Health Professional specific data for Focused Professional Practice Evaluations (FPPE).
Performs other duties as assigned.