This position is responsible for organizing and supporting the operational, financial and personnel activities for the medical/dental staff services department at Children's, including but not limited to credentialing, privileging, contracts, orientation, training, governance, regulatory requirements, conduct and communication - to ensure that qualified, competent providers are providing safe patient care and that they are only performing procedures in which Children's has documented current clinical competence for them to perform.
Essential Duties and Responsibilities
- Credentialing and privileging process for all medical/dental staff and non-employed credentialed practitioners. This includes but is not limited to ensuring that all applicants meet the criteria for all procedures performed, appropriate documentation is obtained for verification of training, competency, licensure, insurance, health status, etc.; ensuring that all criteria is met for hospital compliance as well as regulatory compliance as it relates to credentialing and privileging; working with all hospitals on campus to ensure collaboration in the credentialing of UTSW faculty and other UTSW practitioners; working with the quality department in the establishment, tracking and measurement of quality data as it pertains to the medical staff and allied health staff; ensuring communication throughout the hospital regarding physician practice, approved privileges, physician access, physician oversight, data integrity, etc; and organizing and tracking the maintence of all medical/dental staff and non-employed allied health professionals current credentials and implement suspensions on an as-needed basis.
- Establishment and implementation of minimum threshold criteria for physician competence, activity requirements and practice activity at Children's and assist in the oversight of medical staff governance. This includes but is not limited to working with the Division Directors in developing and providing oversight for competency requirements, physician policies and procedures, rules and regulations and maintaining up-to-date bylaws to govern the medical staff and ensuring implementation of these requirements and governing documents as well as the joint affiliation agreement with the University, as well as provide guidance to and support of all elected officers, division directors and other medical staff leadership with all program, department, service or hospital needs.
- Regular oversight and follow-up with the Focused Professional Practice Evaluation and Ongoing Professional Practice Evaluation requirements as outlined by each Division Director and in conjunction with HIM and Medical Staff Quality.
Licenses & certifications
- Two-year Associate's degree or equivalent experience required
- Four-year bachelors degree or equivalent experience preferred
- Certification through the National Association of Medical Staff Services (NAMSS) as a Certified Provider Credentialing Specialist (CPCS)
- Certified Professional Medical Staff Management (CPMSM).
- Certification must be obtained within one year of hire or one year of eligibilty per NAMSS requirements, as applicable.
Specific knowledge, skills and abilities
- Medical staff coordinator/credentialing experience in a hospital setting preferred
- Detailed knowledge of the standard credentialing practices and privileging requirements as well as knowledge of the Joint Commission and CMS standards as they relate to credentialing, privileging and medical staff governance
- Excellent communication, attention to detail and problem solving skills required.
- Basic knowledge of the Conditions of Participation for Centers of Medicare and Medicaid Services and HIPAA guidelines.
- Advanced knowledge and experience in MS Word, Internet browsers and credentialing software is required.
- Light - Exerting up to 20 lbs. occasionally, 10 lbs. frequently, or negligible amounts constantly and may require walking or standing to a significant degree.
- 2 years ago - save job
Children's Medical Center is private, not-for-profit, and is the seventh largest pediatric healthcare provider in the nation. As the only...