Senior Director, Medical Staff Services
US-ID-Boise
Provider
Req #: 98108
Type: Full-Time
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Overview: The Senior Director, Medical Staff Services provides support, leadership, and oversight of the critical functions of medical staff credentialing, privileging, contracting, provider enrollment and peer review for the health system. An innovative and strategic leader, the Senior Director will drive quality business outcomes through continual monitoring and improvement of operational activities/workflows, team performance/development, and cross-functional relationships. St. Luke's Health System is Idaho's largest employer with 17,000 employees and a medical staff of over 3,000 credentialed providers. Locally owned and operated, St. Luke's services the communities in southern Idaho and eastern Oregon within 4 acute care hospitals, 4 critical access hospitals, 7 Medical Staffs and more than 320 ambulatory sites. What You Can Expect: * Responsible for managing and implementing the activities of the organized Medical Staff to conform to regulatory, accrediting, and legal requirements in coordination with Medical Staff leadership, department/committee chairs and system/hospital leadership. * Provides strategic oversight for responsible areas, administers and coordinates operational activities including operational workflows, credentialing requirements, compliance standards, delegated agreements and NCQA requirements. * Manages a comprehensive program of credentials verification of new applications and reappointments. Oversees medical staff privileging, provider enrollment, focused professional practice evaluation, ongoing professional practice evaluation and the medical staff peer review program. * Serves as escalation point for internal staff and external contacts regarding resolution of highly complex or unusual business problems that affect major contract functions, performance, or relationships. * Oversees specific compliance (policies, monitoring, compliance of) for credentialing and system deliverables for St. Luke's Health System accreditation. Ensures compliance with regulations governing hospitals/area/service and practice/area/ service. Ensures that policy, procedures and standards are developed, implemented and maintained. * Actively manages finances, participates in budget preparation and is responsible for procedures to support the departments' infrastructure. * Communicates medical staff program priorities, policies, and procedures as it relates to the strategic growth of clinical and system leadership. * Drives the design and development of a robust suite of analytical tools and provider performance metrics that serve to inform enhanced provider performance strategies, priorities, and activities as a key factor in achieving organizational results. * Develops and retains effective relationships with physician and business leadership of key physician groups, ancillary providers, subsidiaries and delivery systems to drive business results. * Ensures the organized medical staffs operates within guidelines established through Medical Staff bylaws, policies and other governance documents that are meant to ensure facility compliance. Accountable for coordinating the investigation or disciplinary actions, procedures, and practices impacting medical staff members. * Actively participates in Medical Staff and appropriate organization Committees. Meets regularly with providers to address all financial, operational, quality and contractual issues in adherence with internal and external regulatory bodies. * Develops and implements clear and documented standard operating procedures for organized medical staff operations (e.g., credentialing/privileging, peer review, provider enrollment, provider communications, and provider on-boarding/off-boarding). Qualifications: * Bachelors' Degree. * 10 year's experience. * CPCS or CPMSM Certification through the National Association for Medical Staff Services (NAMSS). Responsibilities: The Director Senior Medical Staff Services is responsible for the planning, implementation, evaluation and management of medical staff services and credentialing for St. Luke's Health System. This role ensures the strategic oversight and direction of all activities relating to credentialing, privileging functions, contracting and business operations for the medical staff services and centralized verification office departments. * Responsible for managing and implementing the activities of the organized Medical Staff to conform to regulatory, accrediting, and legal requirements in coordination with Medical Staff leadership, department/committee chairs and system/hospital leadership. * Provides strategic oversight, administers and coordinates operational activities including operational workflows, credentialing requirements, compliance standards, delegated agreements and NCQA requirements. * Manages a comprehensive program of credentials verification of new applications and reappointments. Oversees medical staff privileging, focused professional practice evaluation, ongoing professional practice evaluation and the medical staff peer review program. * Serves as escalation point for internal staff and external contacts regarding resolution of highly complex or unusual business problems that affect major contract functions, performance, or relationships. * Oversees specific compliance (policies, monitoring, compliance of) for credentialing and system deliverables for St. Luke's Health System accreditation. Ensures compliance with regulations governing hospitals/area/service and practice/area/ service. Ensures that policy, procedures and standards are developed, implemented and maintained. * Actively manages finances, participates in budget preparation and is responsible for procedures to support the departments' infrastructure. * Communicates medical staff program priorities, policies, and procedures as it relates to the strategic growth of clinical and system leadership. * Drives the design and development of a robust suite of analytical tools and provider performance metrics that serve to inform enhanced provider performance strategies, priorities, and activities as a key factor in achieving results * Develops and retains effective relationships with physician and business leadership of key physician groups, ancillary providers, subsidiaries and delivery systems to drive business results. * Ensures the organized medical staff operates within guidelines established through Medical Staff bylaws and other governance documents that are meant to ensure facility compliance. Accountable for coordinating the investigation or disciplinary actions, procedures, and practices impacting medical staff members. * Actively participates in Medical Staff and appropriate organization Committees. Meets regularly with providers to address all financial, operational, quality and contractual issues in adherence with internal and external regulatory bodies. * Develops and implements clear and documented standard operating procedures for organized medical staff operations (e.g., credentialing/privileging, peer review, provider communications, and provider on-boarding/off-boarding). * Accountable for full employment life cycle for staff to include hiring, performance management, coaching, training, professional development, mentoring, and, if necessary, termination of staff. * Other duties as assigned. Qualifications: QUALIFICATIONS: (Minimum qualifications required for the job) * Education: Bachelors' Degree * Experience: 10 year's experience. * Licenses/Certifications: CPCS or CPMSM Certification through the National Association for Medical Staff Services (NAMSS).
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