at Cook County Government in Chicago, Illinois, United States
Job Description
Job Posting:May 14, 2024, 7:26:35 PMClosing Date:May 29, 2024, 4:59:00 AMFull-time
A.M.
P.M.
Posting Salary:COMPETITIVE
Organization:Health and Hospital Systems
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.
Minimum Qualifications
Bachelor's degree with a minimum of five (5) years prior experience in credentialing within a hospital or managed care organization OR High School Diploma with college level coursework and a minimum of seven (7) years prior experience in a hospital or managed care organization.
Minimum of three (3) years supervisory or management experience.
Experience with provider enrollment and clinical privileging.
Experience with the MSOW legacy/Verity platform system or an equivalent web-based data management program.
Proficiency in Microsoft Office applications.
Preferred Qualifications
Bachelors degree from an accredited college or university.
Certified Provider Credentialing Specialist (CPCS)... For full info follow application link.
COOK COUNTY HEALTH AND HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER
