Medical Staff Specialist 2

Baylor Scott & White Health•Round Rock, TX

10h•Onsite

About The Position

Under general supervision, responsible for coordinating, supervising, auditing, and monitoring the approval process for credentialing and re-credentialing. This includes clinical privileging of the medical staff and delineation of services for the Medical Staff Services Department. This is done through partnership and coordination with medical staff managers and administrative representatives. Functions as a team member to ensure the department's best performance. Provides information and guidance about medical staff bylaws, rules, regulations, and AHP policies. Also provides guidance on JCAHO, CMS, and other regulatory agencies related to medical staff and allied health professionals.

Requirements

H.S. Diploma/GED Equivalent
3 Years of Experience
Certified Medical Staff Coord (CMCS) or
Certified Provider Credentialing Spec (CPCS) or
Certified Prof Medical Services Manager (CPMSM)

Nice To Haves

Certified Provider Credentialing Spec (CPCS), Cert Prof Medical Services Mgr (CPMSM)

Responsibilities

Audits and evaluates processes involved in verifications for medical staff and advanced practice professionals appointments, reappointments and privileges delineations.
Audit applications and review documents, including primary source verification, for credentialing and re-credentialing. Ensure medical staff and advanced practice professional files are current. Follow policies and procedures to obtain required documentation and verification.
Coordinates the processing of applications through the hospital review process. Manages the committee meeting structure. Assures all applications are processed completely and on time.
Responsible for auditing files requested for review during regulatory surveys (TJC, CMS, etc.). Present these files to the surveyor.
Responsible for preparing the final Credentials Report for the Governing Board and the change memo notification to staff after the Board meeting.
Maintains knowledge of medical staff bylaws, rules, regulations, and credentialing policies.
Works with manager or director to ensure findings, conclusions, and recommendations are reported through medical staff committees or leadership. Approved actions are then assigned or implemented promptly.
Contact Credentials Committee Members about the monthly review of credentials files. Serve as a resource to reviewers for any questions.
Coordinates the processing of applications through the hospital review process and committee meeting structure.
Attends meetings and helps with the preparation of agendas, research and committee packets (duties of facility team lead).
Works with manager and/or director and makes recommendations for credentialing and privileging forms as needed.
Oversee ongoing development and revisions of privileges with physician input and committee approval.
Participates in system integration and continuing quality improvement efforts.
Assures appropriate implementation of new credentialing software and ongoing development efforts as I related to regulatory agency requirements for credentialing.
Accountable for the primary interface with Credentials Committee Chairmen, and other key medical staff managers around medical staff issues.
Serves as information resource in credentialing to medical staff and advance practice professionals.
Provides administrative and technical help to medical staff department and committee meetings.
Works with manager or director for follow-up action as needed. This includes composing correspondence for chief or chairperson and distributing materials.
Performs other position appropriate duties as required in a competent, professional and courteous manner.