Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Being a Medical Staff Credentialing Director maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Additionally, Medical Staff Credentialing Director analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
MARKET DIRECTOR, MEDICAL STAFF | Greenville, SC
Bon Secours St. Francis Downtown
Building 317
1 St Francis Dr, Greenville, SC 29601
Reports to Market Chief Medical Officer
Direct Reports (2-3)
Primary Function/General Purpose of Position
The Medical Staff Office (MSO) supports the medical staff organization activities including credentialing, privileging, quality improvement activities and medical staff organization governance. The Director promotes close, effective working relationships between the medical staff and hospital administration.
Essential Job Functions
Basic Functions:
Supervises the personnel of the MSO and their activities
Provides resources to the personnel of the MSO to assist them in carrying out their responsibilities
Assisting in collecting the information for physician call schedules, compiling and cataloguing it. Helping to transfer that information into a publishable and searchable format month to month.
Support the committees of the medical staff and the physicians serving on medical staff or hospital based committees
Supply necessary information and data when appropriate and applicable, i.e., quality improvement, informatics, OR steering, etc
Coordination of special events and initiatives including but not limited to: Educational conferences, Recruitment or interviewing, Parts of physician orientation & onboarding, Doctor’s Day, Physician Wellness, Physician Engagement
Credentialing:
Coordinates appointment and reappointment processes of the medical staff by processing applications, corresponding with outside agencies regarding verification of information and verifying information in credentialing files by contacting primary sources. Works in conjunction with our Credentials Verification Office (CVO) at the system level to accomplish provider credentialing.
Maintains and develops automated systems for monitoring and reporting physician activity needed to support the appointment and reappointment process. Assures proper reporting of quality outcomes and resource management data to support competency based credentialing.
Organizes the materials and agenda for the monthly meeting of the Credentials Committee (CC): 1) Arranges the physical details of the meeting (location, invites, refreshments etc). 2) Takes meeting minutes.
Medical Staff Governance:
Organizes the materials and agenda for the monthly meeting of the Medical Executive Committee (MEC): 1) Arranges the physical details of the meeting (location, invites, refreshments etc). 2) Takes meeting minutes. 3) Prepares any such reports that are then submitted to the hospital board as a result of the MEC’s actions.
Plans, formulates and recommends for approval of the MEC the policies, procedures, programs and other strategies which will further the objectives and requirements of the medical staff and the medical staff office.
Coordinates and maintains governance documents such as bylaws and related manuals as well as the policies and procedures of the medical staff. Assures that there is review of existing policies and governance documents on a regular basis and recommends changes to the MEC as appropriate.
Regulatory & Compliance:
Monitors and ensures that the medical staff efforts meet or exceed standards with local, state and federal agencies; Joint Commission and other licensure approving bodies.
Works with hospital legal counsel to assure that the medical staff bylaws and medical staff credentialing practices are in accordance with current state and federal legal practice.
Reviewing any provider complaints that are presented through our patient safety portal (SafeCare) or in any other format (written or verbal communication from staff, other providers, patient or family members) and appropriately providing feedback on them directly or channeling through to the CMO or designee.
Financial:
Develops and maintains policy and procedures manuals and contractual agreements; reviews and recommends updates as necessary; acts as primary resource person for information/interpretation
Responsible for verifying invoices or timesheet payments for independent physician payments, i.e., medical directorships, or for large contracted physician entities, i.e. hospitalist group
Other Job Functions:
Serve on hospital committees as requested
Lend support to special interdepartmental proejcts as requested
Carry out specific tasks as assigned by the CMO or MEC.
Licensing/Certification
Certification in Certified Professional Medical Staff Management (CPMSM) OR Certified Provider Credentialing Specialist by NAMSS, preferably within one year of appointment
Education
Bachelor’s Degree required
Master’s Degree preferred
Work Experience
5 years experience in medical staff management, credentialing or physician relations
5-10 years in an organizational leadership role can be considered
Training
Demonstrated a basic knowledge of all applicable laws and regulations including Joint Commission guidelines, CMS & State/Federal standards.
Proficient in Microsoft Office Suite
EPIC proficiency (preferred not required)
Skills
Hard/Tech/Clinical Skills:
Maintaining governance documents
Maintaining confidential physician files
Budgeting & Financial Acumen
Evaluate employee performance
Analyzing data or information
Ability to quickly provide information as it pertains to rules & regulations
Soft/Interpersonal Skills:
Attention to detail
Teamwork
Highly organized
Relationship building with physicians
Many of our opportunities reward* your hard work with:All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com