Medical Staff Specialist

*** Monday - Friday, Typically 7:00 to 3:30 pm or as needed to support meetings ***

Job Description:

Under the general supervision of the Manager Medical Staff Services with a strong matrixed relationship to the Vice President Medical Affairs and/or Chief Medical Officers in the region, provides highly skilled support via liaison representation to committees, medical staff departments, physicians and other entity personnel/administration. Performs complex, specialized function-related tasks with minimal supervision.

Duties and Responsibilities

1. Provides oversight of physician and advanced practice provider initial/provisional credentialing and reappointment processes and ensures credentialing activities are completed accurately and within appropriate timeframes.
2. Provides oversight of credentialing by maintaining an accurate, secure, and current database of all physicians and advanced practice providers.
3. Employs critical thinking and independent judgment to evaluate and determine an applicant’s eligibility for Medical Staff membership and privileges. Utilizes various internal and external resources and databases to gather and analyze physician and advanced practice providers credentialing and performance data used in the reappointment, peer review, and performance improvement processes of the medical staff.
4. Leverages systems such as Symplr, RemedyForce, SecZetta, and the Virtual Radiology Portal.
5. Monitors timely and satisfactory completion of mandatory educational and training elements, including, but not limited to, LMS, case logs, EMTALA, and privilege-specific training requirements.
6. Recognizes, investigates, and validates discrepancies and adverse information obtained from credentialing applications, primary source verifications, or other sources.
7. Utilizes critical thinking and discretion to maintain peer review and professional conduct protection, escalate safety and quality concerns, and recognize legal implications of credentialing functions.
8. Collaborates with medical staff leaders and/or senior administration regarding confidential and time sensitive issues, to guarantee accurate review of provider credentials and qualifications.
9. Drafts appropriate correspondence utilizing knowledge of state statutes and legal guidelines in requesting additional information from external medical and legal sources.
10. Manages the collection and compilation of performance data for physician and advanced practice provider’s quality profiles, including references for low volume providers.
11. Compiles, evaluates and presents accurate and complete initial/provisional and reappointment applications, as well as all pertinent credentialing and accreditation information to Medical Staff leadership, Credentials Committee, Medical Executive Committee and the Board of Directors for review and appropriate action.
12. Works collaboratively with survey personnel and Accreditation and Licensure leadership to ensure and maintain compliance with accreditation and regulatory requirements by various regulatory bodies, including, but not limited to, the Department of Health, Centers for Medicare and Medicaid Services, The Joint Commission and/or Det Norske Veritas.
13. Provides input as a subject matter expert to draft revisions of system and entity governing documents, Medical Staff Rules and Regulations and privileging criteria to ensure and maintain accreditation and regulatory compliance.
14. Provides support to the medical staff, particularly elected and appointed Medical Staff Officers.
15. Provides assistance in orienting new medical staff members to entity protocols and services.
16. Interfaces between multiple departments, committees, administration, medical staff, CVO and Peer Review.
17. Compiles, evaluates, and presents data for and prepares regularly scheduled and ad hoc reports, analyses, and statements.
18. Prioritizes and organizes work requests, reacting to urgent time-sensitive needs by activating the department help chain, as appropriate, and follow-up, as needed.
19. Actively participates within the Organization’s Lean Daily Management System.

Qualifications

• Minimum Experience:
  • 1-5 years of experience in medical staff services.
  • Min Field of Expertise Business Administration, Healthcare.
• Minimum Education:
  • Associate Degree.
• Skills:
  • Medical Terminology; excellent interpersonal/communication skills; computer skills.