Careers

Manager Credentialing | Medical Staff Services

Rapid City, SD USA Full time 25_368

Apply

Current Employees:

If you are a current employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Job Summary

This position will oversee and coordinate the activities of the credentialing staff (coordinators and specialists). The incumbent in this position will support the Director’s reporting functions to the Credentialing Committee and the Board of Directors. The incumbent will be responsible for ensuring compliance for all peer review activities and document management. The incumbent is responsible for managing peer review/ code of conduct processes directly supporting the medical staff leaders in the process ensuring compliance with state and Federal laws and CMS COPs and Joint Commission accreditation standards.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)

*Flexible scheduling

Job Description

Essential Functions:

  • Works closely with MH’s legal department, Department Director and Chief of Staff to support the Peer Review policy and the Code of Conduct policy through the monitoring, scribing, and document management and outcome tracking as per the Code of Conduct and Peer Review policies ensuring HCQIA/HIPAA compliance
  • Works in conjunction with Department’s Director to in service to all newly appointed medical staff leaders and committee members
  • Supports the Chief of Staff in preparing the peer review reports for the CPC meeting
  • Supports the Director in the daily operations of the Department
  • Participates in the identification of the department’s KPIs
  • Monitors the credentialing process, ensuring compliance with the NCQA and TJC standards
  • Supports Director in managing incoming data from contracted credentials verification organization and other sources
  • Identifies and communicates critical information on provider status with PHO and or payor in a timely manner to Director.
  • Responsible for the Department’s credentialing budget line items
  • Supervises the team’s meeting outputs ensuring all approved/recommended actionable items are processed and reported back to originating meeting
  • Supports credentialing team in prepping for compliance surveys
  • Provides support to director with legal requests
  • All other duties as assigned.

Additional Requirements

Required:

Education - Associates degree in Business/Management or combination of equivalent years of experience and/or education can be considered to meet the Associates degree requirement

Preferred:
Experience - 5+ years Medical Staff experience; 5+ years Management experience
Education - Bachelors degree in Health Administration

Certification - Certified Professional Medical Services Management (CPMSM) - Accredited University or accredited training professionals

Physical Requirements:
Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Business Administration

Job Family

Business Services

Department

RCH Medical Staff Services

Scheduled Weekly Hours

40

Shift

Employee Type

Regular


10 Monument Health Rapid City Hospital, Inc.

Make a differenceEvery day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

Apply