Responsibilities:
POSITION SUMMARY:
Under the direction of and in collaboration with the System Director of Medical Staff Services, the Manager provides leadership and oversight of the day-to-day functions of the Medical Staff Services Department for South Texas Health System. Under the direction of the System Director, designs, develops and manages the day-to-day duties and functions of medical staff credentialing, privileging, and peer review processes. To assure regulatory compliance and organizational goals and objectives, manages appropriate work flow design, utilization and maintenance of provider data integrity within the data systems, monitors and audits the provider data, credentialing and privileging processes and quality of work, and problem resolution. Accountable duties responsibilities assigned may include, but are not limited to, call schedule management; Medical Staff meeting management, including scheduling, planning, Agendas, Minutes, and follow-ups to assure compliance with regulatory and parlimentary procedure; screening locum tenens and management of their billing. , auditing of credentialing and peer review documentation for compliance with regulatory and governing documents. Under the direction of the System Director, actively participates in the development and maintenance of appropriate Medical Staff Governance documentation (Medical Staff Bylaws, Credentialing Manual, Fair Hearing Manual, and General Policies of the Medical Staff). Under the guidance of the System Director, actively collaborates with the System Director of Quality, the Chairs of the Medical Staff Committees, Chairs of the Medical Staff, and Clinical Service Chiefs.
Qualifications:
QUALIFICATIONS:
1. Minimum of 3-5 years Medical Staff/Credentialing operations, supervisory or management experience in a hospital, clinic, health maintenance organization (HMO) and demonstrated leadership abilities and strong communication skills/interact with sophisticated customers is required.
2. Knowledge of healthcare, marketing, and managed care strategy and have the ability to set priorities, manage multiple demands effectively and function independently.
3. Knowledge of credentialing software, MS Office, Outlook, Internet tools; advanced knowledge of computer applications and word processing required.
4. NAMSS CPCS certification required and/or certification within two years of hire.
5. Must demonstrate commitment and adherence to STHS’s Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.
EDUCATION / LICENSURE:
1. Bachelor’s degree in Business Administration, Health Services Administration or related field and 3 years experience in a healthcare environment, or an equivalent combination of education and experience.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
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