When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.Job Type:RegularScheduled Hours:40Work Shift:Day (United States of America)This position reports to the Director and manages the day-to-day operations of the Medical Staff Services Office. Works collaboratively with the Manager of Provider Enrollment, Medical Staff Leadership, and Hospital Leadership to organize and maintain systems that coordinate the credentialing and re-credentialing process for all Lahey Hospital and Medical Center (LHMC) providers.Job Description:Essential Duties & Responsibilities including but not limited to:
Collaborates with the system CVO, Hospital Leadership, and Legal Counsel in assisting providers with the application process for timely appointment, reappointment, clinical privileges, and expirables in accordance with Medical Staff Bylaws, Rules and Regulations, hospital policies and procedures and in accordance with The Joint Commission (TJC) and National Council for Quality Assurance (NCQA) requirements and other state and federal regulatory agencies as required.
Manages the timely credentialing, re-credentialing, and clinical privileges of LHMC providers
Manages coordinates the timely submission of information for the delegation audits by insurance plans
Oversees the integrity, accuracy, and completeness of database entries
Oversees and manages the maintenance of electronic provider records as required
Collaborates with physician leadership in the development of new, or revision of, current privilege forms.
Prioritizes work and provides guidance and direction to Medical Staff Office coordinators and on occasion of other staff assigned to assist with special projects.
Conducts regular MSO staff meetings.
Responsible for the hiring, training, mentoring, ongoing professional development, and evaluations of all team members.
Accountable for all departmental budgetary matters including variances.
Frequently assesses the productivity of departmental and develops business strategies to ensure effective business operations.
Responsible for the development of new policies, review and revision of current policies, and the compliance thereto.
Coordinates all aspects of the Credentials Committee, Medical Executive Committee, Medical Staff Appointment Committee of the Board, and other medical staff committees (as assigned) to include the agenda, minutes, reports, and any required follow-up.
Oversees, coordinates and manages the FPPE and OPPE process.
Maintains a working knowledge of and compliance to The Joint Commission (TJC) and National Committee for Quality Assurance (NCQA) TJC and NCQA standards as well as of the organization’s Medical Staff Bylaws, Rules and Regulations, and applicable medical staff and hospital policies.
Exemplifies a culture of excellence and customer service in all processes with all internal and external customers and all external representation of Lahey Hospital & Medical Center.
Maintain strict adherence to the Lahey Hospital & Medical Center Confidentiality policy.
Incorporate Lahey Hospital & Medical Center Standards of Behavior and Guiding Principles into daily activities.
Comply with all Lahey Hospital & Medical Center Policies.
Comply with behavioral expectations of the department and Lahey Hospital & Medical Center.
Maintain courteous and effective interactions with colleagues and patients.
Demonstrate an understanding of the job description, performance expectations, and competency assessment.
Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
Participate in departmental and/or interdepartmental quality improvement activities.
Participate in and successfully completes Mandatory Education.
Perform all other duties as needed or directed to meet the needs of the department.
Minimum Qualifications:Education: Completion of a graduate or undergraduate degree in healthcare or related field, or equivalent related experience commensurate with a graduate or undergraduate degree.Licensure, Certification & Registration: Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Staff Management (CPMSM) strongly preferred or willingness to achieve said certifications within 5 years.Experience: At least two years management experience working in a Medical Staff Office or CVOSkills, Knowledge & Abilities: Knowledge of credentialing database system(s) and associated applications strongly preferred. Excellent interpersonal and communication skills Ability to work under minimal supervision and to adapt quickly to changes within the environment. Knowledge of MD-Staff credentialing softwareFLSA Status:ExemptAs a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.Equal Opportunity Employer/Veterans/DisabledFull-time