Mgr, Credentialing, MSS

Florida Medical Clinic•Lakeland, FL

4d•Onsite

About The Position

The Medical Staff Services Credentialing Manager is responsible for overseeing the development, implementation, and integrity of the initial credentialing and reappointment activities in accordance with regulatory and accreditation standards, as well as the Orlando Health Bylaws, Policies and Procedures, Rules & Regulations. This position also manages team member functions and accountability.

Requirements

Bachelor's degree in Healthcare Administration and Management, or a related field OR 8 years of experience in Medical Staff Services credentialing and operations may be substituted for bachelor’s degree.
CPCS or CPMSM certification required within 2 years of hire.
Five (5) years of experience interacting with hospital administration, Medical Staff Leadership, Medical Staff physicians, credentialing activities and/or two years directly related medical staff support experience.
Significant experience in use of workflow systems and development of reporting.
Experience with change management and streamlining of workflow processes.

Responsibilities

The Manager, Credentialing, Medical Staff Services effectively implements administrative and operational activities of the Medical Staff and its Leadership.
Operationalizes results of discussions, recommendations, and actions of the Medical Executive Committee and the Credentials Committee.
Exhibits extensive attention to detail and requires attention to detail from all team members.
Exhibits and promotes within the Medical Staff Services team excellent customer service to Medical Staff leaders, medical staff members, medical staff applicants, hospital administration, and internal and external customers.
Implements all credentialing and privileging processes and procedures for all physicians and allied health practitioners, including establishing qualifying criteria for initial appointment.
Formulation and revision of all application materials; professional profiling for reappointment.
Assists direct leader, in concert with legal counsel and Medical Staff Leadership, to facilitate amendments to Medical Staff governance documents to ensure compliance with regulatory, statutory, legal, and accreditation bodies and their required standards, as well as with Medical Staff Bylaws, Policies/Procedures, and Rules & Regulations for all facilities.
Assists direct leader with physician investigations (both behavioral and clinical competency), notifies practitioner of adverse action, and administers the Fair Hearing & Appeal Process, as required.
Primary responsibility for orientation and training, system upgrades/updates, and systems reporting to all downstream systems from the credentialing database workflow system.
Creates implements and reconciles clinical privileges to numerous internal clinical service areas.
Responsible for planning, organizing, leading and directing Medical Staff Services credentialing team activities; appropriately addresses staffing needs, hires, trains, evaluates, coaches and manages team, including establishing goals and objectives for the development of departmental human resources.
Assists direct leader with preparing, tracking, and manages fiscal budget and restricted account.
The Credentialing Manager will ensure that the credentialing database workflow system use is maximized.
The Credentialing Manager of the Medical Staff Office is a supportive, effective, efficient team member dedicated to meeting the needs of the Medical Staff and its Leadership.
Educates team members on organizational objectives and ensures their understanding of the team's part in meeting those objectives.
Manages various personnel functions including hiring, work assignments, coaching plans, and disciplinary actions for the medical staff office personnel.
Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
Maintains compliance with all Orlando Health policies and procedures.
Operates with independent judgment on behalf of the Chief of Staff and the Credentials Committee Chairman.
Coordinates and works effectively with the Health Information Management, Regulatory, Infection Control, Quality Teams, and all other departments that impact the Medical Staff at the organization.
Participates in regional and National Associations for the advancement of the medical staff organization, credentialing and privileging, and medical staff services professionals. Represents Orlando Health through community interaction and related organizations.
Continually updates skills, knowledge and certification. Conducts literature reviews and research on changes in medical staff privileging and makes proposals to enhance credentialing and privileging activities within the organization.
Actively participates in professional organizations, including FAMSS, etc. for networking purposes.