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Medical Staff Services Manager (Req#: 21137)

February 20, 2013 - February 26, 2013
Location:Tyler, TX
Salary Range:$47,784-62,162
Employment Type:Full Time
Department:Medical Staff Services 3152
Description:Responsible for the UTHSCT medical staff credentialing and privileging activities including new appointments, reappointments, managed care delegated credentialing contract agreement functions, physician quality profiles, revisions and adherence to the medical staff bylaws, rules and regulations and policies, medical staff meeting flow and structure, compliance with regulatory and accrediting agencies (i.e. TJC, NCQA, CMS), and preparation of Medical Staff Services budget according to university rules and under the direction of the Director of Clinical and Academic Affairs. Responsible for the medical administration and medico-legal aspects of the medical staff organization and serves as essential link between senior management, nursing and medical staff to promote and enhance communication and positive working relationships. Ensures compliance with the accrediting and regulatory agencies (TJC, NCQA, CMS, TMB) in regards to credentialing/medical staff while developing and maintaining a working knowledge of statutes and laws.
Duties:Maintains a working knowledge of and writes revisions to Medical Staff Bylaws/Rules & Regulations for ongoing compliance with accrediting and regulatory agencies; develops policies and procedures to successfully implement medical staff, performance review and accreditation standards. Disseminates to appropriate parties. Responsible for daily operations of the credentialing department, including supervision of staff, and develops, manages and monitors processes and procedures that support the credentialing, re-credentialing, and provider set up process. Coordinates the managed care credentialing audits, including submissions of reports and review of delegated credentialing contracts, as required for enrollment in managed care plans. Responsible for the Medical Staff Meetings and information flow to various committees. Serves on medical staff and quality committees to ensure compliance with set standards. Assists in development and planning activities, as applicable, for educational and professional growth of the medical staff. Coordinates the teaching staff faculty title assignments for the clinical medical staff departments in accordance with the U.T. Regents’ Rules. Directs the coordination of the medical staff continuing education risk credits data entry according to U.T. Systems standards. Directs the coordination of the U.T. Professional Liability Plan enrollment and disenrollment according to the U.T. Systems’ standards and performs account reconciliation. Fiscal responsibility for department budget and budget preparation and submits budget to the Director of Clinical and Academic Affairs. Maintains credentialing software database and provides medical staff intranet information. Designs and produces reports from the database responsive to request for information. Adheres to HIPAA guidelines and Personal Sensitive Information policy and maintains confidentiality of all files, correspondence, quality files, peer review activities, and special projects. Understands the basis for confidentiality of Medical Staff matters and appropriately applies levels of security to requests for information. Manager of Medical Staff Services will supervise Administrative Officer III and Credentialing Specialist and assign duties to them to assure Medical Staff Office functions are achieved. Assists Director of Clinical and Academic Affairs with physician and midlevel practitioner recruitment by placing ads, posting positions online, screening applications, verifying credentials prior to interviews, assisting with travel arrangements for candidates, coordinate interview schedules and escort candidate during visit. Upon successful recruitment, responsible for sending employment and credentialing paperwork.
Bachelor degree in related field or 5 years of hospital medical staff/credentialing experience in lieu of college education.
Minimum five years of credentialing/medical staff experience. Proficiency in use of computer software programs, including a credentialing database system and Microsoft Office.

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