Manager-Medical Staff Services & Payer Relations-8005 - Kingman Regional Medical Center

• Provides overall strategic, budgetary, and operational leadership for Medical Staff Services. Manages the day-to-day operations including staff development and training.
• Coordinates with Medical Staff leadership to administer Medical Staff functions including credentialing, privileging, reappointment, governance and bylaws, support services, policy and procedure, accreditation and coordinating medical staff events and functions.
• Maintains working knowledge of all relevant bylaws, accreditation standards, and policies and procedures to ensure compliance. Assists with review and updating of bylaws and departmental policies and procedures and processes upon KHI board approval.
• Responsible for preparation, organization and follow up involved with regulatory compliance related to MSS Performance.
• Plays a key role in the development of systems and procedures that promote clinical performance and superior delivery of care.
• Assists with research and development of privileging criteria for consideration when updating delineation of privileges cards.
• Manages processes and compliance for the following: Expiring reports (BLS, ACLS, licensure, COI, reappointment, EMTALA, supervision agreements, etc.), monthly credentialing and privileging letters, monthly and annual calendar development, budget (to include required reports), off-site bank account (in collaboration with the Chief-of-Staff), and content maintenance for Medical Staff information on KHI intranet.
• Manages and maintains the credentialing and privileging management software. Ensures protected health information is stored in the confidential medical history section of the software.
• Serves as a resource to, and collaborates with, providers and other staff to advance the quality of providers and patient safety to the facility.
• Produces letters, obtains required signatures, and distributes letters/privileges following each KHI board meeting.
• Assists with identification and implementation of process improvement projects.
• Distributes communications to privileged providers as requested by physician leaders, and Administration.
• Facilitates ongoing development of meeting agendas. Prepares meeting minutes and conducts required follow-up. Communicates unfinished business to responsible individual(s).

Education: Bachelors Degree in Business or related field

Certification: None

Licensure:None

Experience: Three years of experience in medical staff administration or comparable po0sition

Knowledge, Skills, and Abilities:

• Excellent leadership and team-building skills.
• Highly motivated, and detailed orientated
• Ability to exercise mature and sound judgment in the development and implementation of programs,

policies, and procedures.

• Effective interpersonal, public speaking, and writing skills.
• Ability to analyze and interpret data and prepare concise, accurate reports; knowledge of current state

and federal regulatory requirements.

• Working knowledge of provider enrollment processes, rules, and regulations as it relates to Managed

Care, Medicare, and Medicaid.

• Solid understanding of medical industry terminology
• Thorough understanding of the contractual agreements with major health plans and enrollment policies.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contracted payers.

Certification: NAMSS Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS)

Experience: Five Years of Experience in relation field of capacity

Exposure Categories: Category III: Expected duties do not have potential for exposure to blood, body fluids

or tissues.

• Ability to sit for 6-7 hours daily, either at a desk or at a computer terminal.
• Ability to speak clearly in front of a group of people.