Supervisor - Medical Staff Credentialing

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Supervise and coordinate the day-to-day operations of the Medical Staff Administrative office. Responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing process.  Facilitates all aspects of credentialing, including appointment, reappointment, monitoring and privileging for medical staff and allied health practitioners.  Ensures compliance with accrediting and regulatory agencies (Joint Commission, DOH, CMS) regarding credentialing while developing and maintaining a working knowledge of the statutes and laws.  Responsible for the accuracy and integrity of the credentialing and clinical privileging database system and for ensuring the timeliness of credentialing/re-credentialing verification. Responsible for time and attendance and payroll processing for all Medical Staff employees.

 B.    Essential Job Qualifications

1.     Education: Minimum 2-year degree or 3-5 years healthcare related experience required.  BA/BS preferred.

2.     Experience:  Minimum of 5-10 years of work experience in medical credentialing for medical staff within a hospital setting.  Previous lead and or supervisory experience. Proficiency with MS Office, Outlook, Visio, Cactus. 

      3.   Training/Certification:  NAMSS CPCS certification preferred.

4.     Licensure:     

      5.   Other: Self-directed person with strong organizational skills. Must be detailed-oriented and a team player.  Ability to multi-task and be able to work in a busy office environment. Strong interpersonal and communication skills a must.

C.    Job Specific Contacts

1.     General Contacts: Vice-President & CMO, Medical Directors, Clinical Directors, Chiefs of Service, Medical Staff President, Chairperson of Credentials, Medical Records office personnel, Quality Assurance Office personnel, other hospitals & HMOs, malpractice carriers.

2.     Job Provides Direction to: Credentialing Assistant, Credentials Coordinator, Medical Staff CME Coordinator, Executive Assistant to VP & CMO, Community Liaison and  Volunteers.

D.    Environment and Demands

      1.   Environmental Demands: Active Medical Staff office with high volume, which, includes interacting with physicians and administrative personnel.  Demands can be stressful as deadlines need to be met via meetings schedules.

      2.   Essential Physical and Cognitive Demands, Manual Dexterity: Ability to:

·        meet the demands of a busy Medical Staff Office.

·        use office equipment, which includes the computer, fax machine, Xerox, Dictaphone and scanning equipment.

·        handle several projects at one time while meeting primary responsibilities.

Part I: Hospital-Wide Standards

A.  Organizational

Demonstrates adherence to Montefiore Nyack Hospital “We Care” standards including:

WORKING TOGETHER “I will commit to work together in a courteous, respectful manner.  I will demonstrate a positive spirit of service with all employees with whom I interact.”

I will:

• Place team success above individual recognition.
• Be receptive to new ideas and approaches within my workplace.
• Offer assistance generously without hesitation.

EMPOWERMENT “I will be accountable, responsible, and self-directed in all aspects of my work at all times.”

I will:

• See projects through to ensure completion.
• Problem solve with patients, family members, and other employees.
• Follow up to ensure a resolution.

COMMUNICATION “I will demonstrate positive communication in a clear, courteous and appropriate manner at all times.”

I will:

• Use effective verbal and written communication to patients, families, visitors, and fellow employees using the principles of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank You)
• Use positive communication in my tone of voice, body language, and choice of words.

APPEARANCE “I will dress in a manner that reflects a professional and positive image of the hospital at all times”

I will:

• Maintain a clean, neat, and professional appearance.
• Adhere to the Hospital's dress code policy.
• Promote and adhere to Montefiore Nyack Hospital's guidelines regarding a safe and clean work environment for employees, patients and visitors.

RESPONSIVENESS “I will demonstrate the ability to provide timely feedback and communication to patients, visitors, and coworkers.”

I will:

• Respond empathetically.
• Apologize for delays and concerns.

EXCELLENCE IN SERVICE “I will strive to ‘do my best everyday’ in exceeding customer expectations.”

I will:

• Anticipate and address my patients’ and customers’ needs.
• Avoid negativity and exhibit a “can-do” attitude.
• “Manage up” fellow employees, physicians, departments, and the organization, to increase patient confidence both internally and in the community.

B.    MISSION/STRATEGIC PLAN:

Participates in activities which support the mission of the hospital

C.  JOB SPECIFIC COMPETENCIES:

      Demonstrates the required job specific technical/professional knowledge, skills and abilities. *

1.   Responsible for coordinating, monitoring and maintaining the credentialing and re-credentialing process.

2.   Facilitates all aspects of credentialing, including appointment, reappointment, monitoring and privileging for medical staff and allied health practitioners.

3.   Responsible for training and performance assessments of new hires on all aspects of the credentialing and re-credentialing process. Ensures all staff are in compliance with hospital policies.

4.   Monitor and track training progress for new hires and provide feedback to CMO.

5.   Ensures compliance with accrediting and regulatory agencies (Joint Commission, DOH, CMS) in regard to credentialing while developing and maintaining a working knowledge of the statutes and laws.

6.   Responsible for the accuracy and integrity of the credentialing and clinical privileging database system and for ensuring the timeliness of credentialing/re-credentialing verification.

7.   Duties including the gathering, verification and evaluation of confidential healthcare provider credentials, as well as contacting and following up with facilities to obtain documentation relevant to the credentialing process and data entry of all credentialing information provided by a facility.

8.   Participate with assigned committee and team projects (i.e. audits) as required.

9.   Take minutes and provide follow-up to the Credentials Committee.

10. Maintain/organize files, correspondence and administrative material.

11. Supervise and coordinate the credentialing process in all aspects related to the credentialing of physicians and allied health professionals.

12.Oversee the verification process with respect to all aspects related to the credentialing of physicians and allied health professionals in a timely manner, ensuring compliance with all applicable regulatory requirements.

13. Supervise and direct all work assignments of subordinate staff.

14. Regularly evaluate the performance of staff and provide feedback regarding standards met and or the need for improvement.

15. Review and approve biweekly timecards for payroll processing and monitor staff time and attendance records.

16. Service as the primary contact for Medical Staff Administration inquires that require escalation to department management as well as regulatory or health system changes impacting the workflow of the Medical Staff Administration department.

Part II:  Employee Performance Standards

A.   CUSTOMER SERVICE:

      1.   Demonstrates the ability to create a positive interaction with the customer.

      2.   Demonstrates positive communication with people of different cultures, values and beliefs.

      3.   Demonstrates the ability to acknowledge customer concerns and       

            takes corrective action.

4.   Demonstrates compliance with identified customer service behaviors.

      5.   Provides escort to customers when necessary.

B.   PERFORMANCE IMPROVEMENT:

      1.  Participates in Department/Hospital-wide activities which improve

                        processes and/or outcomes.

      2.  Utilizes resources to maintain and improve self development and

                        knowledge.

      3.   Complies with licensure and/or certification requirements.

     4.    Participates in annual competency assessment.

 C.  Budget:

     1.    Demonstrates fiscally prudent use of equipment and supplies.

     2.    Utilizes charge process for supplies/equipment.

D.  PROJECTS/ASSIGNMENTS:

    1.  Completes projects/assignments within projected time frames and expectations.

Addendum: 

Age Specific Competence         FOR THOSE STAFF WITH REGULAR CLINICAL CONTACT

(Attach supporting documentation of assessment of competency)

1.     Within the scope of practice, assumes responsibility, as necessary, for the assessment,

      treatment and care of patients of all ages, from neonate to geriatric.

2.     Displays competency in obtaining and interpreting the patient’s behavior based upon an understanding of cognitive, biopsychosocial, and aging processes.

3.   Displays an understanding of the developmental needs of the patient when planning and implementing treatment or services.