POSITION SUMMARY
The Medical Staff Coordinator and Quality Analyst is responsible for the following activities : The organization of medical staff functions and systems, NCQA certification, facilitating audits related to payor delegation for credentialing, assesses user needs, develops and implements modifications of electronic and record keeping systems. Supports the organization is retrieval of clinical and / or administrative data using various query tools. This position is full-time, onsite at CRMC in Crosby.
The Medical Staff Coordinator and Quality Analyst reports to the Quality Manager and has a reporting relationship with the Chief Medical Officer.
POSITION QUALIFICATIONS
- Education and Experience :
Associate's degree in health information technician or other health related field preferred.
Minimum of one year credentialing and privileging experience in a medical setting preferred.Familiarity with CME and mandated certifications process preferred.Familiarity with FPPE / OPPE requirements preferred.License / Certificates :Certified Provider Credentialing Specialist (CPCS) preferred; willing to become certified when employment and experience criteria met.
Aspires to achieve the Certified Professional Medical Services Management (CPMSM) credential.Certification in clinical informatics, project / program management, and / or Lean Six Sigma certification preferred.Special Skills and Aptitudes :Self-direction with good organizational, analytical and interpersonal skills.
Knowledge about the credentialing process-initial appointment, privilege delineation, focused and ongoing monitoring, and reappointment.Excellent computer skills using Microsoft Office (Word, Excel, Power Point), web-based programs, internet research. Knowledge / familiarity with credentialing / privileging software program such as Symplr, Cactus, and M-files preferred but not required.Exhibit high degree of responsibility for confidential matters.Excellent interpersonal skills and ability to work effectively and efficiently with healthcare professionals internal and external to CRMC.Motivated problem solver who can work independently, yet take direction and adviceAbility to interpret and apply regulations, Joint Commission, CMS.Well developed, analytical and problem-solving skills with the ability to understand and interpret clinical data.Ability to successfully complete multiple projects simultaneouslyESSENTIAL RESPONSIBILITIES
Medical Staff Coordination :Gather and verify credentialing criteria per regulatory and professional practice guidelines. May involve research with external resources.
Maintain credentialing database ensuring accuracy and completeness.Assist Credentials Committee / Medical Executive Committee with development of privilege criteria, privilege delineations, and other documents necessary for an effective credentialing process.Coordinate and ensure medical staff certifications are up to date; work closely with education department to ensure courses are offered when needed.Work closely with providers to ensure they complete credentialing process in a timely manner.Organize and maintain medical staff files within Quality Department.Coordinate and gather OPPE data and provider feedback, including medical record completion and suspensions.Coordinate and ensure completion of FPPE initial competency.Prepare reports to present Credentialing, FPPE and OPPE to appropriate leaders or committees.Maintain knowledge of Joint Commission, State and Federal regulations related to Medical Staff organization. Assist with policy an procedure maintenance, assuring alignment with CRMC Medical Staff and APC's Bylaws, Rules, and Regulations.Assist with medical staff meeting coordination as assigned, committee notification, drafting agendas, taking and drafting minutes as assigned.Medical staff services liaison for requests from external customers.Demonstrate Standards of Excellence when other duties are assigned.Process Improvement :Develop and manage process improvement initiatives to include detailed data analysis, process analysis, report generation and documentation.
Conduct concurrent / retrospective reviews for the purpose of identifying opportunities for improvement in the delivery of patient care.Provide support to clinical staff and other departments to ensure compliance with federal, state, local and accrediting agency regulatory requirements.Complete the Plan, Do, Study, Act cycle.Recommend and / or implement process improvement related to the potential of quality medical care and service.Regulatory Compliance :Monitor change, correction and clarification in applicable regulatory / accrediting body requirements and recommend adjustments to the quality plan.
Take a pro-active approach to prevent any violations to policies and regulations established by the medical center, local, state, and federal government.Conduct data analysis within regulatory monitoring programs to ensure compliance with established nationally recognized quality patient outcomes as required by NCQA, TJC, CMS, QIO's, other state and federal agencies, and other national data registries through concurrent review and retrospective abstraction.The estimated starting pay range for this role is $69,868 to $77,199. Actual pay rate offered depends on many factors including each individual employee's experience level, preferred education / certifications, along with market conditions.
Benefits
Flexible schedule
Competitive wages
Medical, Dental, Vision, & Life insurance options
HSA option
401k contribution
Paid Time Off
Location : Cuyuna Regional Medical Center
Quality ManagementSchedule : Full Time, Professional
Salary : $69,868 - $77,199
