Medical Staff Specialist
- Medical Staff Services
- Chicago (Lincoln Park)
- Full time
- Day/evening
Position Summary:
The
Medical Staff Specialist is accountable for ensuring the hospital credentialing
and privileging processes (including but not limited to primary source
verifications, analysis and evaluation of verifications and privileges
requested, and completion of application for Credentials Committee) are
completed efficiently and effectively in accordance with established regulatory
agencies, accreditation organizations, Medical and Dental Staff Bylaws, and
Hospital and Medical Staff policies for initial applicants and reapplicants to
the Medical and Dental Staff.
Essential Job
Functions:
-
Credentialing initial appointments: Releases all initial
applications and criteria for membership and status through the
Pre-Application Process. Receives, processes and evaluates all applications
for completion. Performs primary source verification to include receipt of
responses and follow-up. Analyzes all information and documents received and
makes decisions to accept, to initiate further investigation, or escalate
review to Manager. Prepares completed applications for review from quality
review to review by Credentials Committee.
-
Privileging for initial applicants: When clinical privileges are requested
on Pre-Application, releases delineation of clinical privileges forms and
related criteria. Receives, processes, and evaluates for completion. Performs
primary source verification of criteria for each privilege requested. Analyzes
verifications against privileges requested, and makes decisions to accept, to
initiate further investigation, or escalate review to Manager. Prepares
completed requests for privileges for review from quality review to review by
the Credentials Committee.
-
Reappointments and renewal of clinical privileges: Ensures
forms are edited annually and maintained in compliance with current
regulatory, accreditation and organization standards. Prepares and maintains
reappointment data reports in MSO for Windows program. Evaluates the volume of
reappointments to be processed, makes decisions on how reappointments will be
processed and advises Manager.
Ensures efficient and timely process of reappointment applications and
renewals of privileges. Analyzes primary source verifications and quality
reports and makes decision to accept, to initiate further investigation, or
escalate review to Manager. Completes reappointments and renewal of privileges
to the review by Credentials Committee.
-
Provides
guidance and assistance to applicants and reapplicants, division and
department heads, practice administrators or managers, and partner
representatives such as PFF, CMMG, CSF, and CCPA, on initial and reappointment
application deficiencies, standards of regulatory agencies, accreditation
organizations, bylaws or hospital and medical staff policies, and any other
issues relative to the credentialing and privileging process.
-
Receives and processes all requests for temporary privileges
and additional privileges, ensuring regulatory, accreditation and
organizational policy compliance. Analyzes requests and makes decisions to
forward for approval based on completeness of request and established criteria
and policy.
FTE status: FT-80
Requirements
-
Bachelor’s degree
in business, organization management or health care related degree preferred
or minimum three years experience in medical staff credentialing and
recredentialing process.
-
Certification/Licensure/Registration. Certification by National Association of
Medical Staff Services as a Credentialing Specialist (CPCS) is preferred or
minimum three years experience in medical staff credentialing and
recredentialing process.
-
Working knowledge of regulatory and accrediting organization
standards.
-
Must have
experience with a JCAHO or NCQA audit.
-
Extensive knowledge
and experience working with Microsoft applications such as Microsoft Word,
Excel, Access, PowerPoint and Visio with the ability to operate standard
office equipment (examples: photocopy machine, facsimile machine, calculator,
etc.). Ability to type at least
40 wpm is preferred.
-
Ability to work
under pressure, handle numerous interruptions without losing the attention to
details of the task interrupted, be detail oriented, and have excellent
cognitive and communication skills.