50204477 – SE – Medical Staff Affairs Operations Manager

POSITION SUMMARY:

Under the supervision of the Director of Medical Staff Affairs and Credentialing, the Operations Manager is responsible for managing the general operations of the Medical Staff Office related to credentialing and privileging of the Licensed Independent Practitioners (LIPs) at the BMC community hospitals.  Through comprehensive knowledge of medical staff affairs, they will provide high level management of the credentialing and privileging process to ensure approvals move forward successfully and timely. The Operations Manager is responsible for maintaining accurate LIP records in credentialing software suite, as well as implementing system enhancements and procedures to support organizational growth and improve operational efficiency.

Position: Medical Staff Affairs Operations Manager        

Department: Medical Staff Admin

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Responsible for the timely response to LIPs for applications and the coordination of submitted applications for either appointment or reappointment to the Medical-Dental Staff.
• Assures that all credentialing procedures comply with the requirements of the Board of Registration in Medicine, the Joint Commission, the Bylaws of the Medical-Dental Staff and insurance companies.
• Manages workflow of application submissions to assign files for processing by the Credentials Coordinators.
• Maintains primary database for all LIP information at BMC community hospitals, overseeing the maintenance of records and participating in continuous improvement to examine processes and automation techniques to make operations more efficient.
• Manages hospital privileging process for appointment/reappointment applications with Medical Executive Committee and Credentials Committee meetings, including but not limited to scheduling, preparing notices, reports, and other pertinent documents.
• Prepares completed applications for approval process with Committee, including addressing clarifications and details based on anticipated inquiries during Committee process to ensure timely approval.
• Facilitates the approval process through the credentialing software suite, and is responsible for follow-up with approvers and reviewers to ensure completion by proposed start dates/reappointment dates.
• Leads and participates in reviews and audits by regulatory agencies or third-party payers, as appropriate.
• Provides training and oversight to Credentials Coordinators, participating in performance review process with Director.
• Provides backup and assistance to the Director of Medical Affairs & Credentialing, and Associate Director of Medical Affairs, as necessary.
• Perform other duties to serve the operations and function of the medical staff office as assigned.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required)

JOB REQUIREMENTS

REQUIRED EDUCATION AND EXPERIENCE:

Associates degree or equivalent experience required

Requires 10 years of experience in a Medical Staff Office or credentials verification organization. 

PREFERRED EDUCATION AND EXPERIENCE:

Bachelor’s degree preferred.

CERTIFICATIONS, LICENSES, REGISTRATIONS REQUIRED:

N/A

CERTIFICATIONS, LICENSES, REGISTRATIONS PREFERRED:

CPSC: Certified Provider Credentialing Specialist, preferred

KNOWLEDGE, SKILLS & ABILITIES:

• Extensive knowledge of credentialing procedures / requirements.
• Ability to work professionally with all levels of personnel to establish and maintain collaborative working relationships with providers, chiefs of service, department directors, administrative staff, and outside agencies.
• Strong communication, time management and organizational skills required to keep a very large and complex system running efficiently.
• Ability to identify and solving problems in the credentialing and enrollment process as they arise.
• Ability to prioritize duties, meet deadlines
• Ability to maintain sensitive and confidential information
• Knowledge of and ability to operate various computer software applications, including but not limited to Outlook, Word, Excel, and Power Point.
• Able to function independently and perform routine department procedures without supervision.

Equal Opportunity Employer/Disabled/Veterans

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