Efficiently supervise the staff and workflow of the credentialing department on a daily basis. Responsible for input and maintenance of the Medical Staff Credentialing and Privileging System. Provide day-to-day operational direction to the Credentialing Coordinators in the Medical Staff Office. Assists in the coordinator and direction of overall operations of the Medical Staff Support function, including, but not limited to: Medical Staff Office, Credentials Office and Medical Staff Peer Review function. Serves as primary point of liaison between Senior Management and Medical Staff.
Essential Job Duties:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
- Supervises Credentialing Coordinators in the Medical Staff Office. Handles personnel issues, to include disciplinary actions and growth plans. Hires new employees as vacancies occur. Determines schedules and reviews timesheets for payroll.
- Manages and oversees all clerical functions of the Medical Staff Office, ensures that all in-house, external and community physician requests are fully addressed.
- Manages the process of current licensure, insurance and certification requirements; ensures all licensure, insurance and certifications are current.
- Manages the credentialing software entry process in accordance with applicable federal, state, the Joint Commission and Medical Staff requirements. Continually monitors for accuracy.
- Manages the process to grant employees of our physician offices access to the AAMC electronic medical record.
- Supports Medical Staff Leadership. Facilitates communication between CMO, administration, MEC, the Board of Trustees, Department Chairs, Service Chiefs and Medical Directors.
- Supervises credentials staff to create minutes of the Credentials Committee, refers recommendations from the Credentials Committee to the MEC.
- Ensures the appropriateness and clean preparations for Credentials Agenda for MEC and BOT. Ensures communication and follow up of all issues receive appropriate follow-up.
- Supervises the credentials staff to process applications for new privileges, modification of privileges and for reappointment. Ensures applications are processed within designated timeframes and are presented for peer reference and Credentials Committee review.
- Facilitates completion of Medical Staff projects, such as Bylaws revisions, Service Rules amendments, and other documentation, as well as other projects as they arise.
- Bachelor's degree
- One to three years demonstrated experience in Quality Improvement techniques; a minimum of two years active experience in JCAHO, HSCRC, HCFA and State and Federal requirements and standards.
- Knowledge of Credentialing regulations and ICD/CPT coding processes and DRG/resource optimization preferred.
- Three to five years supervisory or management experience preferred.
- Excellent written and oral communication skills required.
- Computer skills
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.
Physical Demands -
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.