Admin Mgr Medical Staff Svcs

Department: Physician Services- Medical Credentialing

Status: Full Time, Exempt

Schedule: Monday – Friday, 8am-4pm

Job Summary:
The Manager of Medical Staff Services is responsible for overseeing the day-to-day operations of the Medical Staff Services department to ensure compliance with medical staff bylaws, state, federal, and regulatory standards. This role involves active participation in the Credentials Committee, Medical Executive Committee, and Quality Safety PA Committee of the Board. The Manager will support accreditation readiness and survey processes related to The Joint Commission, NCQA, and Department of Health. Additionally, this position ensures the compliance and audit of the credentialing and privileging processes for medical staff, coordinates practitioner data management, and collaborates with the Medical Staff Health (MSH) Credentialing Verification Organization (CVO) and MedStar Family Choice associates.

Primary Responsibilities:

·        Department Management: Develop and implement departmental goals, objectives, policies, and procedures, ensuring compliance with regulatory and accreditation requirements. Manage departmental staff, including selection, training, and performance evaluations.

·        Credentialing & Privileging: Oversee the credentialing and re-credentialing process for medical staff, including auditing applications, ensuring data accuracy, and managing temporary privileges. Ensure compliance with CMS, TJC, NCQA, and state and federal standards.

·        Operational Support: Collaborate with leadership to prepare departmental budgets, reports, and correspondence. Support medical staff functions, including participation in relevant committees and meetings.

·        Audit & Compliance: Manage the audit and compliance of credentialing files, including data entry and documentation accuracy. Ensure adherence to policies, procedures, and regulatory standards for initial and reappointment credentialing.

·        Collaboration & Policy Development: Work closely with various hospital departments and medical staff leadership to develop, revise, and implement credentialing, privileging, and medical staff services policies and procedures.

·        Accreditation & Survey Support: Assist in the preparation for accreditation surveys and ensure readiness for The Joint Commission, NCQA, and Department of Health visits.

·        Professional Development: Maintain up-to-date knowledge of medical staff services and credentialing best practices by engaging with industry organizations (e.g., NAMSS, MAMSS), webinars, and training.

Minimum Qualifications:

·        Bachelor’s degree in related field.

·        Minimum of 3 years’ experience in credentialing and/or medical staff services management. Equivalent experience in areas related to regulatory, quality, risk management and compliance will also be considered.

·        Certified Provider Credentialing Specialist (CPCS) or CPMSM - Certified Professional Medical Services Management within 1 Year Required.

·        Other related certification, such as Certified Professional Healthcare Quality (CPHQ), Registered Health Information Administrator (RHIA), Certified Professional in Healthcare Risk Management (CPHRM), or Certified Professional Compliance Office (CPCO) may be considered equivalent upon initial hire.