JOB TITLE: Medical Staff Credentialing Manager

DEPARTMENT: Medical Staff Services

LOCATION: John H. Stroger Hospital

SHIFT: Days

Job Summary

The Medical Staff Credentialing Manager is responsible for managing the daily operations of the credentialing department for the processing of all health system practitioners and non-practitioners’ appointments and reappointments throughout Cook County Health (CCH) and affiliates. The Medial Staff Credentialing Manager is accountable for establishing and implementing an effective credentialing program essential to meet contractual. state, federal and accreditation requirements. The manager serves as a liaison for all pre-assessments and annual audits and provides considerable input into ongoing compliance and re-accreditation. This position is responsible for identifying and recommending initiatives as a result of evaluation of the health plan's activities and member population need with regards to numbers of adequate and qualified providers. In addition, this position provides oversight and guidance to the Credentialing Team.

General Administrative Responsibilities

Collective Bargaining

• Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals.
• Participate in collective bargaining negotiations, caucus discussions and working meetings.

Discipline

• Document, recommend and effectuate discipline at all levels.
• Work closely with labor relations and/or labor counsel to effectuate and enforce applicable Collective Bargaining Agreements.
• Initiate, authorize and complete disciplinary action pursuant to CCH system rules, policies, procedures and provision of applicable collective bargaining agreements.

Supervision

• Direct and effectuate CCH management policies and practices.
• Access and proficiently navigate CCH records system to obtain and review information necessary to execute provisions of applicable collective bargaining agreements.

Management

• Contribute to the management of CCH staff and CCH’ systemic development and success.
• Discuss and develop CCH system policy and procedure.
• Consistently use independent judgment to identify operational staffing issues and needs and perform the following functions as necessary; hire, transfer, suspend, layoff, recall, promote, discharge, assign, direct or discipline employees pursuant to applicable Collective Bargaining Agreements.
• Work with Labor Relations to discern past practice when necessary.

Typical Duties

• Manages all aspects of the assignments for initial credentialing, re-credentialing and privileging process, including collection of Focuses Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE) reports.
• Identifies need for and leads staff in development and revision of policies and procedures governing Credentialing.
• Oversees Provider credentialing to include development. revision and maintenance processes and tools for support of the Credentialing Process.
• Develops audits for Credentialing activities.
• Oversees credentialing audits using criteria relevant to clinical area and provides recommendations to Department Director and Credentialing Committee. Serves as resource to facilities as needed to facilitate compliance with delegation oversight.
• Conducts validation reviews of Credentialing Team work to ensure accuracy and completeness.
• Oversees the audit process, development of quality improvement reports for analysis of results, development of improvement activities and implementation of corrective actions.
• Assists Director in the organization and operation of the Credentialing Committee/Subcommittees. which includes preparing for presentation.
• Maintains database for Credentialing activities.
• Collaborate with and maintain open communication with all departments within to ensure effective and efficient workflow and facilitate completion of tasks/goals.
• Performs other duties as assigned.

VETERAN PREFERENCE

• Meet the minimum qualifications for the position.
• Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, “Are you a Military Veteran?”
• Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list and Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable.

OR

A copy of a valid State ID Card or Driver’s License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing.

BENEFITS PACKAGE

• Medical, Dental, and Vision Coverage
• Basic Term Life Insurance
• Pension Plan
• Deferred Compensation Program
• Paid Holidays, Vacation, and Sick Time
• You may also qualify for the Public Service Loan Forgiveness Program (PSLF)

For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/

• Degrees awarded outside of the United States with the exception of those awarded in one of the United States’ territories and Canada must be credentialed by an approved U. S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents bust be presented at time of interview.

• Please note all offers of Employment are contingent upon the following conditions: satisfactory professional & employment references, healthcare and criminal background checks, appropriate licensure/certifications and the successful completion of a physical and pre-employment drug screen.

• CCHHS is strictly prohibited conditioning, basing, or knowingly prejudicing or affecting any term or aspect of County employment or hiring upon or because of any political reason or factor.