Credentials Manager – Medical Staff Services – Winter Park

  • Adventist Health System
  • Orlando, FL, USA
  • Oct 04, 2017

Job Description

Credentials Manager - Medical Staff Services - Winter Park
Winter Park Memorial Hospital seeks to hire a Credentials Manager who will embrace our mission to extend the healing ministry of Christ.

Facility Profile:
Nestled among the oak-shaded, brick-paved streets of one of the most picturesque hometowns in the country, Winter Park Memorial Hospital has continuously served the residents of Winter Park and its surrounding communities for more than 50 years. Chartered in 1951, the hospital has grown from the visionary efforts of a handful of Winter Park residents and community leaders, to a 307-bed acute care facility that is a model of community health and wellness. Over the years the hospital has continually expanded to meet the needs of the community, adding an upscale obstetrics and Level II Neonatal Intensive Care Unit at The Dr. P. Phillips Baby Place, cancer care at the Florida Hospital Cancer Institute, Winter Park, and state-of-the-art surgery, recovery and rehabilitation at the Florida Hospital Orthopedic Institute. Together with the community we serve, we're building a model of community health and wellness for generations to come.

Department Profile:
The FH Medical Staff Office (MSO) develops, manages, performs, and directly supports governance, and credentialing and privileging activities related to over 2,500 Medical Staff members and Advanced Health Practitioners (AHP). The MSO supports the FH organized Medical Staff leadership and committees by providing expert consultation and ensuring its leaders and members adhere to the FH Medical Staff Bylaws, Rules and Regulations, and all pertinent policies. MSO are responsible for remaining current and complying with all state, federal and non-federal national regulations and requirements on credentialing processes. Ensures that all Medical Staff and AHP members are properly vetted according to the requirements of the Medical Staff Bylaws, The DNV, State of Florida, Centers for Medicare and Medicaid Services (CMS), and other regulatory requirements by providing primary-source and accurate verification services.

Work Hours/Shifts:
Monday - Friday, 8:00am - 5:00pm

Job Summary:
The Credentials Manager is responsible for the system medical staff credentialing and privileging operations. He/she provides direct supervision to a professional support staff in administering all aspects of the credentialing services with a strong emphasis on the delivery of quality, efficiency and superior service. The Credentials Manager possesses and maintains current knowledge of the Medical Staff Bylaws and Policies, Rules and Regulations, Joint Commission standards and other regulatory requirements, Department Policies and Procedures, and hospital policies and procedures. The Credentials Manager implements these policies and standards to ensure that credentialing operations are in compliance in order to further patient safety, maintain hospital accreditation, and protect the hospital from liability. Works with the officers of the Medical Staff, department chairpersons, and administration to support and enhance the functions of the organized medical staff and to fulfill the mission and goals of Florida Hospital. Actively seeks to model the achievement of excellence and the delivery of outstanding customer service. Accepts responsibility for the cultivation and maintenance of relationships that are equally respectful to all and that value diversity. Promotes teamwork by personally adopting principles of caring and integrity.

Knowledge, Skills, Education, & Experience Required:
  • Demonstrated management and supervisory skills including delegating, coaching, mentoring, and disciplining
  • Demonstrated knowledge of credentialing and privileging principles
  • Demonstrated ability to think independently, exercise reliable judgment and problem solve
  • Demonstrated written and verbal communication skills, including writing of policy and job descriptions.
  • Demonstrated ability to maintain emotional stability, calm disposition and diffuse confrontational situations.
  • Demonstrated ability to react effectively to unplanned circumstances, demands and challenges including flexible work schedules.
  • Demonstrated ability to function in a fast-paced, high-pressured environment.
  • Demonstrated interpersonal skills and ability to relate cooperatively and constructively with customers, co-workers and staff; ability to maintain confidentiality.
  • Demonstrated intermediate computer skills, credentialing software and information systems knowledge; ability to generate management and production reports, documents and correspondence independently.
  • Bachelor degree in health services administration and/or
  • A minimum of 5 years previous experience in an acute care facility Medical Staff Services environment.
  • Management and supervisory credentialing experience
  • Bachelor degree in Health Services Administration (preferred)
  • Experience within a multi-entity healthcare system. (preferred)
  • Strong knowledge of medical terminology (preferred)

Licensure, Certification, or Registration Required:
  • Current Certified Provider Credentials Specialist (CPCS) and/or Certified Professional Medical Staff Management (CPMSM) certification. Certification must be maintained.

Job Responsibilities:
Demonstrates through behavior Florida Hospital's Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork as outlined in the organization's Performance Excellence Program
  • Manages and administers all Credentialing and Privileging operations including processing of Medical Staff and Allied Health applications and the channeling of applications and requests through appropriate Medical Staff leadership and committees. Supervises the performance of the Credentialing Coordinators, Specialists and other credentialing staff for appropriate and timely assessment of appointment and reappointment to the Medical Staff, credentialing and recredentialing of Allied Health Professionals, delineation of clinical privileges, and associated credentialing functions.
  • Activities within this function include, but are not limited to, assignment of work responsibilities, meeting with support staff weekly to review of applications in process, to identify issues, provide leadership for resolutions and to monitor quality of processes and systems. Evaluate problem applications provide appropriate guidance to staff and physician leaders. Informs Director to provide awareness and to achieve commonality for resolution if necessary. Assess systems and develop improved processes, while remaining in compliance with credentialing guidelines, state and federal statutes, standards and regulations. Train and provide guidance on an on-going basis with emphasis on education in credentialing, standards, privileging, bylaws, rules and regulations and enhancement of customer service. Oversee correspondence issued by support staff pertaining to Medical Staff credentialing matters. Delegate tasks for committee meeting preparation and coordination, and special projects, as deemed appropriate. Manage staff's vacation and PDO time to allow for adequate coverage. Determine the qualifications and competence of credentialing staff. Interviews and selects credentialing staff. Directs, provides and/or delegates to the Sr. Credentials Coordinator, the orientation and training of new credentialing staff. Reports to Director credentialing data, significant issues, process improvement, staffing performance and planning.
  • Performs employee evaluations on a 90-day/annual basis in accordance with Florida Hospital policy to evaluate performance, address concerns, and set goals. Employee feedback, whether positive or educational, is provided at minimum on a quarterly basis, or more frequently if necessary. Revises job descriptions and develops standards of performance as appropriate.
  • Manage the Credentialing Coordinators and Specialists who provide delegated credentialing verification services for Florida Hospital Health Care System and Centra Care Medical Staff in accordance with their respective bylaws and policies.
  • Provides the same oversight to staffing as described under #2 for these functions.
  • Works jointly with department management to establishing department goals in the areas of finance, diversity, Christian service, Performance Improvement, Employee Engagement, and other areas. Develops Departmental Policies and Procedures and Standard Operating Procedures related to the Credentials Operations and staff.
  • On an ongoing basis is responsible for planning and implementation of the yearly staff Education Plan. Schedules quarterly presentations according to the Plan's listed topics and others chosen by support staff on an ongoing basis. Orients new staff and educates them on the Department Policies and Procedures.
  • Provides consultation to Medical Staff, Allied Health Professionals, Administration and other hospital departments. Address and facilitate issues and concerns of Medical Staff leadership, Medical Staff, Allied Health Professionals, legal counsel, administration, hospital personnel and others.
  • Maintain current knowledge of medical staff bylaws, rules and regulations and policies and procedures, and external accrediting standards as well as state and federal regulatory requirements. Provide appropriate interpretation and clarification of standards and requirements. Provide Medical Staff leaders, Medical Staff and administration with necessary reports as required. Act as director in Director's absence. Maintain confidentiality at all times.
  • Continuously safeguards the liability exposure of the Hospital and Medical Staff through the monitoring of compliance with the hospital's medical staff Bylaws, Rules and Regulations, and Policies and Procedures. Shares responsibility with the Director for maintaining compliance with Joint Commission, AOA, NCQA and AHCA standards, Corporate Compliance, FMQAI Compliance (Florida Medical Quality Assurance) - Medicare Attestations, and any other pertinent regulations.
  • In conjunction with Medical Staff leadership, oversees the following medical staff committees: the Medical Executive Committee, the Credentials Committee and the Allied Health Professional Review Panel. Maintains overall responsibility for these meetings which may be accomplished through the delegation of some of these to the credentialing staff.
  • Activities within this function include, but are not limited to, updating the composition of these three committees as provided by the Medical Staff Bylaws, Medical Staff President and appropriate chairpersons; coordination of meeting set up and notification of members; managing deadlines and agenda items; managing the preparation of agendas and providing Chairman and Director with agenda and pertinent data according to set deadlines; compilation of all meeting materials for distribution, prior to and at meetings. Summarizing meeting discussions and preparing minutes within one week of meeting. Accountable for all follow-up items, documentation and coordination of meeting actions; channeling action items, and in the event of deferral, obtaining additional information as required. Provides electronic broadcast of the Medical Executive Committee to all members of the Medical Staff within one week subsequent to approval by the Committee. Forwards recommendations and supporting material to the assigned Coordinator for Professional Affairs and Board meetings within three (3) days of Medical Executive Committee. Maintain original minutes in record books within one week of meeting, and provide to appropriate support staff for annual archiving.
  • Responsible for the granting of clinical privileges in accordance with the medical staff Policy on Appointment, Reappointment, and Clinical Privileges and in the Policy on Allied Health Professionals. Included is the management of temporary privileges for Medical Staff members and non-staff physicians and Allied Health Professionals. Oversees staff to compile required documentation for temporary privileges, mandated queries, verifications, and obtains necessary approvals and notifies appropriate administrators, Medical Staff and hospital personnel when privileges are granted.
  • Assists Medical Staff leaders in the development of new privileging guidelines. Provides guidance to support staff relative to clinical privileges and related correspondence, appropriate data entry and forms development.
  • Responsible for training of new physician leaders including new Department Chairmen in credentialing and privileging. Responsible for the selection and provision of credentialing and privileging materials to train and educate physician leaders.
  • Participates in department or system-wide committees, task forces or activities, when requested.
  • Stays abreast of latest developments, trends and techniques in areas of responsibility through participating in conferences, workshops, seminars and reading professional literature. Shares knowledge gained with staff and assimilates into department policies and procedures.
  • To ensure effective management of support staff and to ensure effective quality improvement, performs other work-related duties as necessary.

If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Credentials Manager opportunity with Winter Park Memorial Hospital and apply online today.

Job Keywords:
Credentials Manager, manager, credentials, Medical Staff, Physician Credentialing