The Director of Medical Staff Office is responsible for administering medical staff services for Cook County Health (CCH). This entails overall management of credentialing services for physicians and mid-level practitioners; and overseeing privileging services and appeal process for physician and third-party providers. This position is responsible for maintaining continued accreditation and compliance with Federal, State and regulatory requirements. Serves on the Credentialing Committee and advises the leadership team on credentialing and privileging regulatory compliance, policies and procedures. Manages the medical services staff and oversees the accreditation compliance budget.
This position is exempt from Career Service under the CCH Personnel Rules.
General Administrative Responsibilities
Review applicable Collective Bargaining Agreements and consult with Labor Relations to generate management proposals
Participate in collective bargaining negotiations, caucus discussions and working meetings
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
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
Contribute to the management of CCH staff and CCH’ systemic development and success
Discuss and develop CCH system policy and procedure
General Administrative Responsibilities continued
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
Leads the management and operations of the Medical Staff Office for credentialing verification, privileging and physician enrollment for CCH and Managed Care Providers
Ensures timely and proper credentialing and re-credentialing for all Medical Staff with clinical privileges
Oversees the maintenance of the credentialing database and Physician Directory
Researches and recommends information system enhancements to improve the retention and retrieval of credentials
Obtains temporary admitting or consulting clinical privileges with appropriate department chair. Assists practitioners and physicians inquiring about and applying for Medical Staff privileges. Follows through with applications to the appropriate departments/committees
Analyzes and formulates Credentialing and Privileging Policies and Practices. Stays current and knowledgeable on legal and regulatory requirements
Serves as an expert resource on regulatory compliance. Advises Leadership Team on minimizing risk and limiting liability
Supports the Medical Departments with the on-boarding process for Physicians, Mid-Level Practitioners and third-party Providers. May also assist in the orientation program Prepares and oversees budget for Credentialing such as certifications and licensure
Manages the Credentialing and Privileging Services staff
Reports to the Chief Medical Officer
Bachelor’s Degree from an accredited college or university
Active Certification by the National Association of Medical Staff Services (NAMSS) as a Certified Professional Medical Services Management (CPMSM) or Certified Professional Credentialing Specialist (CPCS) or the ability to obtain an active certification within eighteen (18) months of starting this employment
Seven (7) years of full-time experience in Medical Staff Services, Medical Staff Credentialing, and Provider Privileging in a hospital or health system
Three (3) years of experience managing staff
Master’s Degree from an accredited college or university
Three (3) years of experience with Health Plan Credentialing and Privileging
Knowledge, Skills, Abilities and Other Characteristics
In depth knowledge of and the ability to interpret Federal and State Credentialing regulations
Physical and Environmental Demands
This position is functioning within a healthcare environment. The incumbent is responsible for adherence to all hospital and department specific safety requirements. This includes but is not limited to the following policies and procedures: complying with Personal Protective Equipment requirements, hand washing and sanitizing practices, complying with department specific engineering and work practice controls and any other work area safety precautions as specified by hospital wide policy and departmental procedures.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of the personnel so classified.
For purposes of the American with Disabilities Act, “Typical Duties” are essential job functions.
Cook County Health is an equal opportunity employer.
Internal Number: 8045
About Cook County Health
ABOUT COOK COUNTY HEALTH (CCH)
The Cook County Health’s mission is to deliver integrated health services with dignity and respect regardless of a patient’s ability to pay; foster partnerships with other health providers and communities to enhance the health of the public; and advocate for policies that promote the physical, mental and social wellbeing of the people of Cook County.
CCH is comprised of two hospitals, John H. Stroger, Jr. Hospital and Provident Hospital, a robust network of more than a dozen community health centers, the Ruth M. Rothstein CORE Center, the Community Triage Center, the Cook County Department of Public Health, Cermak Health Services, which provides health care to individuals at the Cook County Jail and the Juvenile Temporary Detention Center, and CountyCare, a Medicaid managed care health plan.
The system cares for more than 300,000 patients each year and its physicians are experts in their fields, committed to providing their patients with comprehensive, compassionate and cutting-edge care. Today, CCH is transforming the provision of health care in Cook County by promoting community-based primary and preventive care, growing an innovative, ...collaborative health plan and enhancing the patient experience.
COOK COUNTY HEALTH IS AN EQUAL OPPORTUNITY EMPLOYER