| JOB SUMMARY | | The Medical Staff Services Specialist at North Mississippi Health Services is responsible for supporting effective system and organizational performance as it relates to medical staff services. |
Credentialing:- Perform detailed and thorough review of applications, primary source verifications, and sources provided.
- Recognize potential discrepancies and adverse information, and independently investigate and validate information applications, primary source verifications, or other sources.
- Verify and document expirable using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
- Serve as main point of contact for external queries regarding practitioners’ status, providing responses in a timely matter.
- Complete evaluation of application to determine applicant’s initial eligibility for membership/participation.
- Serve as main point of contact for practitioner during application process, providing timely updates and additional information as requested.
- Compile, evaluate, and present the practitioner-specific data collected for review by one or more decision-making bodies.
- Perform initial or reappointment/re-credentialing for eligible practitioners.
- Process requests for privileges
REGULATORY:- Participates in surveys and audits of regulatory and accreditation agencies or organizations
- Compile quality monitoring data for provider OPPE and FPPE.
- Organize information and data to identify/explain trends, problems, and their causes.
- Participate in an ongoing assessment of governing documents (bylaws/rules and regulations/policies and procedures) to ensure continuous compliance.
- Develop informational/educational documents (newsletters, memos) to communicate critical information regarding organizational programs and policies.
Department Operations:- Coordinate onboarding for new providers to ensure compliance with facility, state and national requirements.
- Maintain credentialing database continuously and consistently to ensure that accurate and current information is available to all stakeholders.
- Securely manage information as the single source of truth by effectively navigating database software and maintaining data integrity.
- Use database software for contracting, training, reporting, as well as integrating with other IT and revenue systems.
- Assist with preparation and ongoing review of operational budget and staff plan(s) that support medical staff services and credentialing functions.
- Audit, assess, procure, implement, effectively utilize and maintain practitioner/provider credentialing processes and information systems (e.g., files, reports, minutes, databases) as outlined by the department.
- Coordinate and support assigned medical staff committee meetings. (ie MEC, Peer etc)
| | QUALIFICATIONS | | | Education | | | | Education Level | Education Details | Required/Preferred | | | | Associate's Degree | in Business or related field | Required |
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Licenses and Certifications
| | | | | Licenses and Certifications | Licenses and Certifications Details | Time Frame | Required/
Preferred | | | | | | | | |
Work Experience | | | | | Number of Years | Work Experience Details | Required/
Preferred | | | 1-3 years | Minimum of 1 year of work experience in the executive or administrative level | Required | | | 1-3 years | Experience in medical services profession | Preferred | | | 1-3 years | Prior healthcare industry | Required | |
Knowledge Skills and Abilities
| | | | | Knowledge, Skills, Abilities | Required/Preferred | Proficiency | | Analytical Thinking: Take all critical information into account, considering interrelationships among issues and implications for other stakeholders. Apply knowledge, expertise, sound judgment and other references and resources as necessary to generate and evaluate solutions and recommendations. | Required | N/A | | Communication: Express thoughts clearly, concisely, and effectively both verbally and in writing | Required | N/A | Confidentiality: Maintain confidentiality regarding legal matters, privacy issues, information
technology, and data integrity | Required | N/A | Flexibility/Adaptability: Ability to adapt behavior in response to new information or
changing circumstances. Work and collaborate effectively in unstructured or dynamic environments and adjust the original objective or plan to allow for the best possible results. | Required | N/A | Information Technology:
Understand information technology concepts, key functions, terminology, and work
products; effectively utilizes information technology. | Required | N/A | Professional Presence:
Displays a credible presence and positive image when representing facility. Develop other people’s confidence in self through consistent action, values and communication. Utilized professional presence behaviors outlined by NMHS | Required | N/A | | Quality Review/Quality: Commit to continuous performance and process improvement. | Required | N/A | Relationship Building: Establish productive, cooperative relationships with peers,
management, and stakeholders both internal and external to the organization. | Required | N/A | Team Building: Work collaboratively and relate effectively to others by practicing, valuing and
embracing diversity of individuals, and fostering respect and equity in
the workplace | Required | N/A | | | | | | | | | | | | | |
SCOPEFreedom To Act:Problem Solving:Impact:Financial Responsibility:- Sales Revenue Target Responsibility:
- Approval Responsibility:
- P & L Responsibility:
- Assets Controlled:
- Controllable Expenses (e.g., Payroll and other budgeted items):
- Total Financial Responsibility:
Budget Responsibility- Primary Budget Responsibility:
- Shared Budget Responsibility:
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