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When you join the growing BILH team youre not just taking a job youre making a difference in peoples lives.
This role is responsible for ensuring consistent compliant and high-quality medical staff services in support of credentialing privileging governance regulatory readiness and professional practice evaluation. The Manager oversees personnel management operational workflows quality improvement initiatives policy alignment and performance metrics.Job Description:
Essential Duties & Responsibilities including but not limited to:
1. Provides direct leadership and oversight of the Medical Staff Services Department (MSSD) team ensuring effective daily operations consistent application of policies staff development performance monitoring and a commitment to operational excellence.
2. Collaborates with the system Credentials Verification Office (CVO) Hospital Leadership and Legal Counsel to support providers through the application process ensuring timely appointment reappointment privileging and management of credentialing expirables in compliance with Medical Staff Bylaws Rules and Regulations hospital policies and applicable regulatory requirements including those of The Joint Commission (TJC) the National Committee for Quality Assurance (NCQA) and state and federal agencies.
3. Oversees staff and ensures the timely and accurate credentialing recredentialing and privileging of providers affiliated with the hospital.
4. Manages and coordinates the timely submission of data and documentation for delegation audits by insurance plans as applicable.
5. Ensures the accuracy completeness and integrity of provider data entered into the credentialing database by the MSSD staff.
6. Oversees and manages the maintenance and organization of electronic provider records in accordance with regulatory and organizational standards.
7. Partners with system and physician leadership to develop new clinical privilege forms or revise existing forms to reflect current practice and regulatory expectations.
8. Conducts regular team meetings to communicate updates address concerns and support team cohesion and performance.
9. Conducts regular staff meetings.
10. Responsible for recruiting training mentoring and evaluating staff as well as fostering their ongoing professional development.
11. Participates in the development and monitoring of the departmental budget including variance reporting and resource planning.
12. Monitors departmental productivity and develops strategies to optimize operational effectiveness and efficiency.
13. Develops new policies and procedures and oversees the routine review revision and enforcement of existing policies to ensure regulatory and organizational compliance.
14. Coordinates all aspects of assigned Medical Staff committee meetingsincluding the Credentials Committee Medical Executive Committee and Medical Staff Appointment Committee of the Boardensuring accurate preparation of agendas minutes reports and timely follow-up on actions.
15. Oversees the implementation coordination and management of the Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) processes.
16. Maintains current knowledge of and ensures compliance with all relevant regulatory and accreditation standards including TJC/DNV NCQA CMS and state and federal laws as well as Medical Staff Bylaws and hospital policies.
17. Promotes a culture of excellence professionalism and customer service in all internal and external interactions and represents the organization positively in all external engagements.
18. Performs other related duties as assigned to support departmental and organizational goals.
Organizational Requirements:
1. Maintain strict adherence to the BILH Confidentiality policy.
2. Incorporate BILH Standards of Behavior and Guiding Principles into daily activities.
3. Comply with all Departmental Policies.
4. Comply with behavioral expectations of BILH.
5. Maintain courteous and effective interactions with colleagues providers and BILH leadership.
6. Demonstrate an understanding of the job description performance expectations and competency assessment.
7. Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to BILH customer service standards.
8. Participate in departmental and/or interdepartmental quality improvement activities.
9. Participate in and successfully completes Mandatory Education.
10. Perform all other duties as needed or directed to meet the needs of the department.
Key Relationships:
Minimum Qualifications:
Required Qualifications:
Preferred Qualifications:
Required Experience:
Manager
Full-Time