Full Job Description
Ensures compliance with DNV and CMS standards specific to Medical Staff. Maintains all MS policies, MS Bylaws and Rules and Regulations in constant state of survey readiness. Develops and generates quality improvement projects for physicians, being the liaison between the Medical Staff and QI Committee. Attends all Quality subcommittee meetings: SCR, MR/MC, Infection Control, ED Code Blue, Pharm. and Therapeutics and others as needed. Researches and/or develops programs for physician education, including maintaining Audio Digest subscriptions. Maintains physicians' credentials files and maintain Medical Staff files in a timely and organized fashion. Processes new applications on practitioners applying for membership and/or privileges and present to CEO, MEC and the Board. Develops and implements a competency program for physicians based on required criteria from DNV and CMS. Builds strong working relationships with department managers to acquire skills to generate reports to complete physician competencies. Organizes MEC and MS meetings, including scheduling, notification, agenda and minutes. Maintains ledger and other documents for the Medical Staff. Responds to reference letter requests for MS. Prepares and maintains a list of current physicians. In conjunction with clinical reporting, audits and enters data as required, working with clinical administration to complete.
Ensures compliance with DNV and CMS standards specific to Medical Staff.
Maintains all MS policies, MS Bylaws and Rules and Regulations in constant state of survey readiness.
Develops and generates quality improvement projects for physicians, being the liaison between the Medical Staff and QI Committee. Attends all Quality subcommittee meetings: SCR, MR/MC, Infection Control, ED Code Blue, Pharm. and Therapeutics and others as needed. Develops and implements an annual Practitioner Survey and presents results to MEC, the Board and managers for potential QI projects.
Researches and/or develops programs for physician education, including maintaining Audio Digest subscriptions.
Maintains physicians' credentials files and maintain Medical Staff files in a timely and organized fashion. Processes new applications on practitioners applying for membership and/or privileges and present to CEO, MEC and the Board.
Develops and implements a competency program for physicians based on required criteria from DNV and CMS. Builds strong working relationships with department managers to acquire skills to generate reports to complete physician competencies.
Organizes MEC and MS meetings, including scheduling, notification, agenda and minutes. Maintains ledger and other documents for the Medical Staff. Responds to reference letter requests for MS. Prepares and maintains a list of current physicians.
In conjunction with clinical reporting, audits and enters data as required, working with clinical administration to complete.
Enroll employed physicians, NPs, PAs, Social Workers, Dietitians into the insurances we PAR with. Included in enrollments are contracted staff (CRNA's and providers that see patients in the RHC).
Maintain a status spreadsheet and follow up status with insurance carriers.
Communicate all information with provider, Patient Accounts and Director of Practice Management.
Reattest information every 3-5 years (per insurance carrier requirements) for providers and facility.
Must be a Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM). Five years of Medical Staff Services experience preferred.
