As our Market Director, Medical Staff Services, you will oversee and coordinate Medical Staff Services for various entities, ensuring that appropriately qualified and experienced medical staff are appointed with defined clinical responsibilities and privileges, all in accordance with professional standards and applicable regulatory requirements.
Every day you will identify opportunities to streamline operations and implement enhanced workflows to improve efficiency and achieve organizational objectives. You will also serve on various Medical Staff Committees, oversee the maintenance of provider information systems, and work with senior leadership to ensure policies and procedures are up-to-date and compliant. You will manage provider systems enrollment, ensure full regional compliance, and keep abreast of changing regulatory requirements.
To be successful in this role, you will demonstrate exceptional leadership in Medical Staff Services, a profound knowledge of MSO operations (credentialing, privileging, compliance), and a proven ability to streamline operations, ensure regulatory compliance, and collaborate effectively with a diverse range of stakeholders.
- Identifies opportunities to streamline current operations and implements enhanced workflows, processes, and procedural changes in order to improve efficiency, eliminate duplication of work at the various entities across the ministry, and achieve operational and fiscal objectives of the organization.
- Serves on local (i.e., facility-based and/or market-wide), divisional (Southeast Division), and national (CommonSpirit Health) Medical Staff Committees/Councils as needed to engage in the launch/roll-out of new systems/initiatives and in national/regional integration efforts.
- Oversees the maintenance of physician information systems, including education, training, experience, licensure, and the production of related reports.
- Works with members of the Senior Executive Leadership Team as well as hospital and medical staff committees; individual providers and/or provider groups; and multiple other cross-functional or cross-organizational teams where diplomacy, sensitivity, conflict resolution, and consensus-building skills are necessary to gain buy-in and support for new initiatives and changes.
- Ensures that department policies and procedures are accurate and up-to-date, in accordance with current evidence-based practices, regulatory standards/elements of performance, and conditions of participation.
- Facilitates overall standardization, integration and operational continuity in collaboration with CHI Saint Joseph Health Leadership
- Work requires significant knowledge of MSO-related operations (i.e., credentialing, privileging, ongoing evaluations, peer review, contract management, provider systems access, medical staff policies and procedures, team building, HR-related functions, etc.) as well as procedures and systems to ensure ongoing compliance with regulatory standards and/or conditions of participation.
- Manages timely and accurate provider systems enrollment processes for employed and contracted practitioners, including initial enrollment, re-enrollment, re-validations, terminations, changes and updates to provider and/or payor records.
- Ensures full regional compliance with internal/external legal and regulatory standards/requirements and ensures that effective control procedures are in place and fully functioning to preclude future improprieties from occurring; monitors the effectiveness of current practices in meeting expectations and producing desired results.
- Keeps abreast of changing regulatory requirements/regulations, professional standards and competitive industry practices impacting assigned functions as well as organizational initiatives/changes with the potential to impact current strategies, programs and resources; determines nature/scope of the impact on existing activities and determines effective response/resolution while maintaining acceptable service levels and work quality.
- Participates in the development/execution of system-wide medical staff initiatives/ programs that meet CHI Saint Joseph Health/CommonSpirit Health business needs and ensures compliance with regulatory requirements; analyzes and assesses the effectiveness of current regional practices in meeting expectations and producing desired results; works collaboratively with the CHI Saint Joseph Health leadership team, management team, CommonSpirit Health representatives, and others to identify and resolve issues impacting the attainment of short- and long-term strategic objectives.
- Anticipates and recognizes evolving factors that influence current/future needs and develops (or directs the development of) plans/programs/projects to support business objectives; understands and ensures the full optimization of available information technology to achieve overall business objectives; recommends strategic/tactical plans to include both short- and long-term business planning with full accountability for achievement of planned objectives; presents and gains support for recommendations and directs project management efforts to develop/implement planning objectives.
- Conducts ongoing assessments of the strengths and weaknesses of the Department to better understand/identify future needs and challenges; evaluates existing systems/programs/priorities and future potential to make recommendations for performance/process improvement initiatives; develops/presents comprehensive recommendations regarding the viability of specific projects and plans/directs process improvement initiatives/projects to ensure achievement of business objectives.
- Serves as system administrator for credentialing database software, ensuring integrity of all data and timely database maintenance; oversees maintenance of system tables and permission levels for system access and/or deletion of system users; reconciles credentialing and/or enrollment data with other systems; analyzes/troubleshoots system errors to determine causes and facilitates problem resolution and training.
- Organizes the sharing of resources between Medical Staff Offices at each CHI Saint Joseph Health location to approach functions in the most cost-effective manner.
