Senior Medical Staff Coordinator

South Shore Health • Weymouth, MA

23h • Onsite

About The Position

This position provides highly-skilled coordination and maintenance of, in accordance with State, Federal, and TJC accreditation, provider credentialing and privileging. Coordinates administrative and clerical tasks; medico-legal issues; maintains critical and confidential credentialing, privileging, and peer review information; executive correspondence; ongoing-professional performance evaluations (OPPE); and focused professional performance evaluations (FPPE). Requires a high degree of confidentiality and critical decision-making, with moderate direction and guidance. It involves complex relationships with administrative staff, Medical Staff, Advanced Practice Staff, Medical Staff Executive leadership, legal counsel, other facilities' medical staff professionals, state licensing bodies, other departmental personnel, and patients, all requiring courtesy, tact, patience, cooperation, and confidentiality. This role demands continued education and experience in Medical Staff Services and hospital credentialing.

Requirements

• No less than three (3) years of experience in hospital credentialing and Medical Staff Services administration.
• Knowledge of medical terminology, hospital credentialing and privileging, and professional executive interface.
• Strong professional verbal and written communication skills.
• Astute judgment in human relations skills to interface and communicate in an articulate manner with Medical Staff, administrators, legal counsel, and hospital personnel.
• Proficiency in MS Office and credentialing software.
• Ability to work with common office software and personnel.
• Highly organized, detail-oriented, and able to handle a multitude of tasks.
• High level of personal computer skills.
• Excellent interpersonal skills.
• Excellent verbal/written skills, including accurate and concise minute, and report presentation skills.
• Knowledge of JCAHO, federal and state regulations.
• Medical terminology knowledge.

Nice To Haves

• Two years college education is preferred.
• National Certification as a Medical Staff Services Professional is preferred.
• Associate's degree in business or equivalent preferred.
• CPCS preferred.

Responsibilities

• Initiates credentialing processes and procedures in accordance with established timeframes.
• Coordinates and maintains all aspects of physician and advanced practice practitioners credentialing processes.
• Assures the completeness and accuracy of the credentialing process in accordance with TJC, CMS, and State requirements.
• Requests additional information from external and internal sources as needed.
• Documents all initial applicants' competencies and primary source verifications for credentialing and privileging.
• Collects and compiles data for provider profiles to analyze practice patterns.
• Responsible for the primary source verifications of all aspects of credentialing and privileging.
• Maintains an accurate, secure, and updated database of provider information.
• Gathers and analyzes provider data used in reappointment, peer review, and quality improvement processes.
• Obtains necessary privileging documentation and clinical activity for establishment and maintenance of competency requirements.
• Provides for timely and accurate collection, transmission, analysis, and reporting of data for CMS, The Joint Commission, NPDB, and peer review statutes.
• Abstracts clinical data from patient encounters for privileging, OPPE, and FPPE.
• Processes focused professional performance evaluations (FPPE) for providers.
• Processes ongoing professional performance evaluations (OPPE) for providers.
• Prepares credentialing and privileging, OPPE, and FPPE for review by Credentials Committee, Medical Executive Committee, Chairpersons, and Administration.
• Plays a key role in the organization’s patient safety initiatives.
• Works collaboratively with Director, Manager, and key department and individuals in developing strategies and initiatives to improve compliance with Medical Staff goals.
• Assists with focus studies to support Medical Staff quality initiatives and performance improvement activities.
• Ensures appropriate improvement follow-up occurs and effective collaboration with appropriate owner when needed.
• Processes Medical Staff Resignations and change of status requests.
• Processes additional privilege requests.
• Assures completeness and accuracy of enrollments of providers in the National Practitioner Databank (NPDB).
• Queries the NPDB as required for various credentialing processes.
• Serves as a resource for Medical Staff, APC staff, and organization teams regarding Medical Staff Bylaws, Rules and Regulations, departmental policies and procedures, regulatory requirements, and parliamentary procedure.
• Processes maintenance of Expirables, including MA Licensure, DEA, MA Controlled substance, Malpractice, AMA certifications, and/or Board certifications.
• Liaises between Medical Staff and administration, communicating sensitive and confidential issues.
• Interacts directly with a variety of internal and external customers.
• Uses judgment and discretion to maintain peer review protection.
• Verifications of affiliation with South Shore Hospital to outside sources.
• Supports and participates in the development of departmental goals, objectives, guidelines, policies, and standard operating procedures.
• Provides executive level administrative office support, including scheduling meetings, drafting correspondence, and preparing information.
• Coordinates all aspects of Medical Staff Committees, including compiling agenda material, documenting minutes, and compiling follow-up memos.
• Ensures all approvals for Credentialing and Privileging are documented.
• Maintains continued professional communications regarding applicants with key organization stakeholders.
• Creates and maintains provider profiles as needed.
• Provides administrative support for hearing committees as needed.
• Maintains ongoing education and compliance with current best-evidenced based Medical Staff Services practices, CMS, TJC, and State regulations and standards and parliamentary procedures.
• Performs all functions according to established policies, procedures, regulatory and accreditation requirements, best-evidenced based practice, as well as applicable professional standards.
• Provides an excellent service experience to all internal and external customers.
• Develops, maintains, and updates Medical Staff Website as needed.
• Contributes and is actively engaged in the automation of credentialing and privileging processes.
• Fosters a "Culture of Safety" through personal ownership and commitment to a safe environment.
• Assists in the preparation for Credentials Committee and other meetings as needed.
• Performs general office tasks including filing, faxing, copying, and answering the main medical staff services phone.
• Participates in the orientation of all new medical staff.

Benefits

• South Shore Health is a not-for-profit, charitable health system offering primary and specialty care, hospital care, home health and community care, emergency and urgent care, and preventative and wellness services.
• We are the largest independent health system in Southeastern Massachusetts.
• We unite top-caliber talent, technology, and service with the wishes and personal needs of patients and their families to develop individualized treatment plans.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree
• Number of Employees: 501-1,000 employees