Director-Executive Medical Staff and Verification Services Position Available In Hall, Georgia

Director-Executive Medical Staff and Verification Services 3.7 3.7 out of 5 stars 743 Spring St NE, Gainesville, GA 30501

Job Category:

Executive Leadership Work Shift/Schedule:

8 Hr Morning – Afternoon Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. About the

Role:

Job Summary The Executive Director of Medical Staff and Verification Services (MSVS) provides leadership, management and operational oversight to the MSVS Department and the Unified Medical Staff of Northeast Georgia Health Systems. The Executive Director works collaboratively with the Chief Clinical Officer, Vice President of Medical Affairs, Chief of the Medical Staff, the Medical Executive Committee (MEC) and additional medical staff leaders (department chairs, committee chairs, etc.) for the purposes of Planning, organizing, directing and coordination of the programs and activities of the medical staff. Further, this role should assist in driving the strategies of the Medical Staff, assure leaders are supported, goals and plans are realized, and there is adherence to the requirements of regulatory and accreditation bodies that are relevant to the organized medical staff. Provides oversight regarding Physician Leadership selection, process, educational programs, and strategic initiatives. The Executive Director owns responsibility to organize and direct a comprehensive and specialized credentialing program to meet regulatory and accreditation bodies for medical staff, employment and managed care affiliations of Northeast Georgia Health System to include Northeast Georgia Medical Center Gainesville/Braselton, Northeast Georgia Medical Center Barrow, Northeast Georgia Medical Center Lumpkin, Health Partners, Northeast Georgia Physicians Group, Georgia Heart Institute, and the Ambulatory Surgery Center(s). This additionally includes support of PSA agreements and Community Connect partners. In this role, the director acts as the primary sponsor for the selected credentialing and verification platform, ensuring health system strategy usage, user access and training program, and security of system information is upheld in accordance with guidelines and standards. Minimum Job Qualifications Licensure or other certifications:

CPCS Educational Requirements:

Bachelor’s Degree required.

Minimum Experience:

Minimum 5-7 years experience in administrative area of health care involving medical staff relations. Credentialing experience strongly recommended. Knowledge of

DNV, CMS, NCQA

standards and state licensure regulations.

Other:

Preferred Job Qualifications Preferred Licensure or other certifications: CPMSM.

Preferred Educational Requirements:

Masters in either Healthcare Administration or Business Administration.

Preferred Experience:

Other:

Job Specific and Unique Knowledge, Skills and Abilities Ability to develop and maintain effective relationships with the medical staff and other professionals in order to engender confidence, respect and dependability. Ability to express ideas effectively, orally and in writing. Ability to maturely handle a variety of problems and situations, sometimes of a critical or urgent nature. Considerable knowledge of medical staff services principles, methods and procedures. Ability to develop and implement methods and procedures for improvement of the comprehensive and specialized credentialing program. Essential Tasks and Responsibilities Medical Staff and Verification Services Department Manages the daily activities of the department including appointment, reappointment, privileging, Focused Professional Practice Evaluation Profiles (FPPE), Ongoing Professional Practice Evaluation (OPPE) and ensures high quality services. Assures compliance with regulatory standards, including staff and medical staff education regarding accreditation standards. Actively participates in survey processes. Develops and maintains teamwork essential for the effective and efficient operation of the department; organize and manage work- flow through supervision of support staff. Monitors departmental performance and productivity to assure appropriate utilization of resources. Anticipates future needs and develops departmental budget and manages in a fiscally responsible manner. Establishes departmental standards, goals and objectives in conjunction with the CMO and organizational health system goals. Medical Staff Provides leadership and strategic direction to the Medical Staff Services Department and is responsible for the accurate and timely privileging committee approval, and onboarding to NGHS medical staff. Develops innovative strategies for improvement to ensure optimal functioning of the department and compliance with all state, federal and regulatory requirements, policies and processes. Plans, formulates and recommends for approval policies, procedures, programs and other strategies which will further the objectives and requirements of the Medical Staff Coordinates and maintains medical staff “governance documents” such as medical staff bylaws, rules and regulations, organization manual and policies and procedures of the medical staff. Ensures that the Medical Staff Bylaws and related regulatory documents are current with state, federal and regulatory requirements and that all processes of credentialing, privileging and medical staff appointment of physicians and relevant licensed independent practitioners are in compliance with the bylaws. Oversees the medical staff practice review functions, ensuring findings are appropriately reviewed, communicated and documented. Supports the health system strategy for variance entry, maintenance, feedback, and reporting. Develops, directs and maintains systems for the organization of the Medical Staff governance and committee structure, including committee charter development and maintenance, ensuring committee reporting and information flow through the appropriate reporting lines of the organization to include the NGHS Board. Supports the medical staff officers and leadership in carrying out their contracted and assigned duties. To include review, interpretation and to provides considered and timely advice to the senior leadership team regarding regulatory guidelines, medical staff bylaws, corrective actions and the fair hearing process, rules, regulations, policies and operations. Handles with discretion issues that are significant, complex, multidisciplinary, sensitive, and confidential. As a liaison between the senior leadership and external constituents, exercises best judgment and decision-making while providing effective and appropriate leadership to staff. Develop and implement policies and procedures for ongoing monitoring of practitioner performance and quality between re- credentialing cycle. Develops and implements physician orientation program for new members and assist in directing an annual education program for medical staff. Supports medical education programs to meet medical staff and organizational needs. Oversees the Medical Staff Engagement Survey and outcomes. To include, operational rollout of the survey, reporting of results, and management of goals or special projects resulting from engagements activities. Provides support for Medical Staff Leadership Council members, Medical Directors when needed, and any medical staff member assigned to special projects on behalf of the medical staff. Oversees the planning, implementation, execution and evaluation of special projects. Works with Medical Staff Leadership and Administration to design and implement Leadership & Development programs to enhance the knowledge and skillset of both groups, including providing support for the program and follow up activities. Coordinates with identified Health System administrators to maintain appropriateness and documentation standards for Health System Physician Medical Directors. Provides ownership and leads system activities as related to the NGHS chosen on-call system. Working with IT designated groups to facilitate access, appropriateness, and corrective actions as needed. Works with GME leadership to facilitate interaction and integration of faculty, residents, and fellows with the formal Medical Staff. Partners with the Public Relations and Communication function to keep the Medical Staff informed on activities of the Health System. Facilitates special events to include Doctors Day, Medical Staff Leadership work sessions, and Capstone presentations. Verification Services & NGHS Credentialing Program Organizes and directs a comprehensive and comprehensive credentialing program to assure the practitioners of participating programs with NGHS possess the credentials, including training and experience, to provide patients with the quality of care consistent with the mission of each participating program. Assures the comprehensive credentialing program meets all requirements of regulatory and licensing agencies of the NGHS Participating programs to include CMS, DNV, NCQA, State of Georgia, etc. Directs the development, enhancement and maintenance of the credentialing database for all NGHS participating programs. Database will be the “source of truth” for participating programs practitioner files. Ensures that credentialing system security access is in accordance with the levels of security assigned to members of each participating program which is necessary for them to perform their assigned credentials file management responsibilities. Maintains systems to identify, and disseminate to others, practitioner demographics, practice information, clinical privileges and other related records and reports. Develops and maintains the Verification Services Operating Manual, Verifications Methods Document, and Data Dictionary, reviewing annually and recommending required changes to meet operational, regulatory and licensure requirements. Responsible for monitoring and documenting compliance with the Verification Services Operating Manual through a Quality Management Program which includes timely file audits, review of data elements and compliance with process time requirements. Reviews and makes recommendations regarding all forms used for credentialing purposes i.e. initial appointment, reappointment, release, requisition for application, etc. for approval by the Verification Oversight Committee. Coordinates regular meetings of the Verification Oversight Committee, which represents all NGHS participating programs to ensure feedback on operational issues and quality improvement of the verification processes. Works collaboratively with all NGHS entities for development of provider enrollment system strategies. Ensures on-going monitoring and update of expirables for all practitioners i.e. licensure, board certification, insurance, DEA, etc. Provides oversight to system integrations with purpose of streamlining NGHS practitioner information. System include NGHS chosen EMR, Regulatory reporting, NGHS.com tools, and any other request for streaming information. Provides Health System reporting needs in relation to Physicians and Advanced Practice Professionals. Reviews request for reports from the credentialing database to ensure appropriateness of the use of the data. Works for resolution to provide appropriate information to meet request.

Physical Demands Weight Lifted:

Up to 20 lbs, Occasionally 0-30% of time

Weight Carried:

Up to 20 lbs, Occasionally 0-30% of time

Vision:

Moderate, Frequently 31-65% of time

Kneeling/Stooping/Bending:

Frequently 31-65%

Standing/Walking:

Frequently 31-65%

Pushing/Pulling:

Occasionally 0-30%

Intensity of Work:

Occasionally 0-30%

Job Requires:

Reading, Writing, Reasoning, Talking, Keyboarding, Driving Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.

NGHS:

Opportunities start here. Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.