Medical Staff Coordinator
High school diploma or GED required
Medical Staff Coordinator serves as an expert in credentialing and accreditation requirements within department and coordinates and assists in the development, planning and operational management of the Medical Staff and Allied Health Practitioner Staff enabling them to fulfill their duties and obligations as defined by national and state regulatory agencies (such as ,TJC, CMS, NCQA, AHCA, AAAHC,) the Medical Staff Bylaws, Rules and Regulations, Credentialing Policy and other related policies. Promotes and enhances good communication and positive working relationships between facility Administration and the Medical Staff. Above all, this position serves to exceed the expectations of patient and all other customers we serve. The scope and nature of the work varies greatly depending on the assignments, which are planned and executed with considerable independence in conformance with the governing documents and regulatory agencies. The Medical Staff Coordinator serves as a valuable expert resource to Medical Staff Leadership and is a role model for best practice for the team.
ESSENTIAL DUTIES AND RESPONSIBILITIES – Other duties may be assigned.
Oversees and monitors the credentialing process and directs team members as appropriate. Manages the flow of information between the Medical Staff Office team, Credentials and Medical Executive Committee members, Medical Staff Leadership (including the Department Chairs and Section Chiefs), and Administration. Ensures continuity of work by collaborating with department chairpersons, administrators, for follow-up and action on issues addressed in committees. Provides guidance when appropriate.
Initiates, Coordinates, monitors, and maintains the credentialing and re-credentialing process in a well-organized manner, pursuant to established policies and procedures. Assures timely processing of all credentialing/privileging functions for licensed independent practitioners, in an efficient manner, for recommendations to the appropriate committees (credentialing committee, medical executive committee, and board approval) in accordance with all governing documents, policies and procedures, and all regulatory bodies. Communicates with all applicants and coordinates with applicable managers and directors to ensure appropriate follow up and follow through. Ensures that all board letters are finalized and mailed within two (2) business days of board action and maintains a copy for the credentials file prior to filing. Prepares a monthly board memo to send to internal staff and others as requested of all board approved actions within two (2) days of the board meeting.
Closely monitors information collection within the department to ensure cognitive analysis and interpretation of all information received has been accomplished, appropriately evaluating the quality of the documentation received, pursuing additional information, if necessary, for effective and comprehensive peer review evaluation. Immediately reports to the Director, Medical Staff Services all information which is adverse to the application (i.e. credentialing issues, adverse letters, gaps on application, peer review recommendations, disciplinary actions, etc).
Manages the credentialing database systems to ensure all updates are made, by the team, in a timely manner as appropriate (demographic information, membership categories, appointment/reappointment dates, clinical privileges, expired information, tracking of FPPE/OPPE, etc.). Explores opportunities to streamline process and improve work flow on an ongoing basis.
Audit credential files in order to maintain ongoing compliance, including but not limited to, ensuring that all expiable are updated prior to expiration.
Coordinates and oversees proctoring activities for the department that support the professional practice evaluation process, including updating the credentialing database for tracking of information.
Coordinates and oversees both the informal and formal credentialing peer review and recommendation process, working closely with the appropriate section chiefs, department chairs, per established medical staff governing documents. Ensures that all quality review information is obtained and reviewed ongoing and prior to the reappointment process for all files; collects and reviews relevant statistical data from leadership of pertinent departments.
Ensures temporary privileges are processed in accordance with the governing documents.
Continuously updates and coordinates orientation and EMR training for new appointments to the medical staff and allied health professional staff, including updates to the process, as it may be amended from time to time.
Reviews, annually, all standardized credentialing forms used in the department for accuracy and updates as discussed and approved by the director, including clinical privilege forms.
Preparation and coordination of medical staff meetings, (including early morning and evenings); attends and prepares meeting packets and minutes as assigned, including follow up and preparation for reporting through the committee structure of the medical staff. Distributes appropriate correspondence (developing and utilizing standardized communication tools), and assures appropriate and timely follow up.
Prepares complex reports for medical staff departments, committees, peer review panels, medical staff meetings, administration and other hospital departments.
Works on various projects with the Director.
Maintains working knowledge of regulatory guidelines, including Medical Staff Bylaws, Rules and Regulations, Credentials Policy, Organizational Functions and Manual, hospital policy. Complies and provides recommendation for implementation of applicable changes to such documents.
Assists in the coordination of and preparation for medical staff hearings.
Processes stipends for medical staff leaders, professional practice evaluations, and emergency room on call contracts and forms.
Performs ongoing audits of the credentialing database and reports deficiencies to the Director.
Responsible for developing and overseeing the emergency room on call schedules in accordance with NCH medical staff governing documents, hospital policy, and EMTALA requirements.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
Minimum of High School or GED required
Minimum of 6 years of experience in an acute care or manager care setting as a medical staff services professional (including medical staff and allied health credentialing); must have worked consecutively in the most recent year and the other 5 years of experience in the last 8 years.
CPCS certification by the National Association Medical Staff Services (NAMSS) is required.
Additionally, CPMSM certification by NAMSS is preferred. If not CPMSM certified at time of hire, shall become certified within two (2) years.
Educational competencies must be met through the National Association Medical Staff Services Professionals (CPMSM or CPCS) with continuous certification required for this position.
Independent judgment is essential in resolving varied problems in compliance with established policies, rules and regulations, bylaws, NCQA and TJC standards.
Experience leading projects and working independently and act as a self-starter.
Ability to prioritize a number of competing tasks and complete to deadlines.
Able to maintain a high level of confidentiality and be diplomatic in approach
Flexible approach, adapting in a fast paced environment
Knowledge of medical terminology