Manager Medical Staff Professional Services

Parkland Health • Greendale, WI

4d

About The Position

Primary Purpose Supports multiple areas of business operations surrounding credentialing, privileging, and medical staff governance. Executes the strategic business plan as well as day-to-day staff and vendor oversight for diverse programs/projects as assigned. Responsible for the daily management of Medical Staff Professional Services activities including staff supervision and development, planning, budget, quality, and facility operations and coordinating patient services to ensure high quality patient care and optimal outcomes. Ensures that the work operations meet internal/external standards for Parkland and affiliated institutions.

Requirements

• Bachelors degree healthcare administration, business administration, or related field.
• Must have five (5) years of expert level Medical Staff Professional Services experience in hospital setting, clinical practice, or managed care that is related to healthcare administration programs such as credentialing, privileging, peer review, professional performance evaluation, quality improvement/assurance, provider education, legal and compliance, risk management/prevention or internal/regulatory audit is required.
• Must have four (4) years of experience serving in a supervisory or managerial capacity within a complex multidisciplinary healthcare system.
• Must have two (2) years of experience working with elements of the Professional Performance Evaluation (FPPE/OPPE) standards.
• Must be certified by the National Association Medical Staff Services (NAMSS) as a Certified Professional in Medical Services Management (CPMSM) or a Certified Provider Credentialing Specialist (CPCS) within twenty-four (24) months of hire or placement in job.
• Must have comprehensive knowledge of hospital accreditation, medical/non-physician staff credentialing, privileging, appointment, and licensure requirements, as well as management of governance documents.
• Must have excellent oral and written communication skills and be able to communicate effectively with Medical Staff, hospital management, and staff level personnel.
• Must have excellent management skills with high employee engagement and emotional intelligence
• Must have strong analytical skills to evaluate complex situations, ability to formulate decisions, and execute a plan of action.
• Must understand risk management concepts, such as identifying, monitoring, and managing potential risks in order to minimize the negative impact on organization.
• Must establish productive, cooperative, positive relationships with subordinates, peers, management, and stakeholders both internal and external to the organization.
• Must possess the ability to understand and respond to others needs and priorities. Give and seek feedback that will increase the productivity of relationships and networks with peers and associates to build a support base.
• Must be proficient with personal computer, spreadsheet, and word processing software.
• Must have experience using MD-Staff or other credentialing/privileging software. Serve as liaison between internal technical staff as well as outside technology vendors.
• Must be able to organize work, set priorities, and determine short- or long-term goals and strategies to achieve them.
• Must have the ability to align communication, people process and resource to drive success.
• Must be committed to continuous performance and process improvement.
• Must be capable of conducting clinical competence evaluations for FPPE, OPPE and Peer Review. Maintain awareness of population health and care transitions: and review health data analytics.
• Must have the ability to write, develop, and implement medical staff bylaws, policies and procedures.
• Must be able to perform ongoing evaluations of procedures to ensure due diligence in review of practitioners information.
• Must have the ability to collaborate and share plans, information and resources with team.
• Must be able to encourage and facilitate cooperation, trust and group identity; and build commitment, team spirit, and strong relationships.
• Must have the ability to work collaboratively and relate effectively to others by practicing, valuing, embracing diversity of individuals, and fostering respect and equity in the workplace.
• Must have the ability to supervise direct reports in a remote environment.
• Must be able to educate, motivate, and inspire top-quality work product from remote workforce.
• Must be committed in fostering a team-dynamic and cohesive, collaborative department with an entirely remote workforce.
• Must have the ability to work collaboratively and relate effectively to others by practicing, valuing, embracing diversity of individuals, and fostering respect an entirely remote workforce.

Nice To Haves

• Two (2) years of experience in provider data management is preferred.

Responsibilities

• Manage Medical Staff Professional Services operations including, but limited to the following: credentialing, privileging, appointment and reappointment processes, clinical competency and professional performance evaluations, peer review, meeting management, governance and assists the medical staff in supporting the organizations mission, vision, and goals.
• Oversee, conduct, participate in, maintain and ensure Medical Staff Professional Services applications, appointments, privileges, credentialing, and administrative support services for the medical staff, and appropriate health professionals are coordinated in a thorough, accurate and timely manner.
• Oversee, conduct, participate in, and maintain current Clinical Competency Evaluations and Peer Review. Support activities related to related to elements of the Professional Staff Quality Management Plan to include coordination of practice evaluation, peer review and provider staff evaluation. Ensures timely and proper notification regarding any probable claims involving peer reviewed cases.
• Comply with Accreditation and Regulatory Standards. Manage compliance with State and Federal Accreditation Standards and Regulatory Requirements. Oversee the development and dissemination of Medical Staff reports. Collaborate with others as needed to ensure compliance with process deadlines and/or regulatory requirements. Ensure timely and efficient process by coordinating the credentialing and privileging of new physicians through the maintenance of credentialing database system. Work collaboratively in an interdisciplinary team approach to ensure physician concerns are addressed through established medical staff processes. Serve as the operational liaison and subject matter expert for all credentialing activity and workflow across the organization, regulatory agencies, and internal and external Parkland constituents. Manage the fulfillment of all Credentialing Department deliverables, including, but not limited to, regulatory reporting requirements and regulatory audits related to credentialing, privileging, professional performance evaluation functions. Effectively develop and execute project plans. Closely collaborate with Parklands strategic leadership team, medical staff committees and regulatory agencies and associations. Execute internal and external communications and education surrounding Medical Staff Professional Service programs. Develop and execute credentialing/privileging management tools, programs, policies and procedures to drive provider satisfaction and continuous performance improvement. Perform other duties as assigned to support the business plan.
• Manage the processing of all Medical Staff and Non-physician Staff credentialing, re-credentialing, Focused Professional Practice Evaluation (FPPE), Professional Staff Peer Review, and Ongoing Professional Practice Evaluations (OPPE) in accordance with Medical Staff bylaws, rules, regulations, Joint Commission, and State/Federal law. Prepare for and attend Medical Staff committee meetings. Provide all necessary meeting documents, assist the Committee Chair with the development of meeting agendas, and prepare and maintain minutes and other documents of the proceedings. Ensure necessary follow up with Medical Staff leadership for committee actions and policy changes expeditiously. Facilitate meetings with leadership to develop on-boarding processes (orientation, training activities) to assist practitioners/providers and to meet education requirements. Interpret and educate the Medical Staff on applicable laws and accreditation standards to ensure appropriateness of internal operations and responsiveness to external change. Collaborate with executive teams to develop and implement orientation, educational and training activities to ensure staffs ongoing competence. Effectively lead and develop medical staff through communication conflict management, building relationships, and maintaining knowledge and expertise in all areas across the industry. Conduct and execute special projects as required. (e.g., implementations of EMR communication, training, etc.)
• Identifies and analyzes the design of jobs, work processes, workflows, etc. for the area and implements appropriate changes to improve effectiveness, productivity, and efficiency that support the overall goals of the department and Parkland. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding. Develops and monitors annual budgets that ensure the department has the necessary funds to carry out the goals and objectives that have been established for the department. Develops, implements, monitors, and revises annual goals and objectives for the department that support the missions and objectives of Parkland. Selects, trains, schedules, motivates, supervises, and evaluates employees making recommendations for disciplinary actions up to and including termination, to ensure maximum utilization of individual and group capabilities. Ensures that assigned employees receive opportunities to further their knowledge.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 1,001-5,000 employees