Description
This position is responsible for assisting with the daily operations of the Office of Integrated Credentialing (OIC), over assigned area/division, a function which provides system-wide primary source verification information to entities/hospitals for USC clients Medical Staff practitioners including initial applications and reappointments. Ensures excellent service in all areas. Provides guidance and motivation to staff to identify activities that can be streamlined and automated. Assists in development and composing of effective credentialing policies, procedures and processes and implements applicable policies and processes within OIC. Ensures compliance with regulatory requirements related to credentialing (such as JCAHO, DNV, NCQA, AAAHC, Title 22, CMS, OIG and NPDB), as applicable. Ensures processes are timely and accurate. Assists with system-wide data dictionary, user training within OIC and throughout the Keck Medicine of USC system (i.e. Medical Staff Services Offices, other administrative offices) as appropriate, for sharing of appropriate database information with appropriate USC/Health System departments and systems, and interfacing with IT for software upgrades and maintenance.. Responsible for maintaining productivity standards and ensuring adequate staffing through seasonal credentialing demands, as needed. Coordinates and manages audits under the direction of the Director.
Essential Duties:
- Management 1. Responsible for supervising work assignments of staff. 2. Responsible for monitoring and maintaining records of credentialing staff work product and productivity, including for remote work. 3. Responsible for committee support (ie agendas, minutes, follow-up) 4. Responsible for development and maintenance of department policies and procedures as well as applications 5. Responsible as resource person, interacting with Chief of Staff and other appropriate medical staff officers, chairs, chiefs and Administrators of clients to facilitate communication and flow of information. 6. Responsible as a lead person for supporting the Director in complying with all regulatory requirements, client deadlines and the USC/Hospital Mission and Core Values. 7. Audits all files for accuracy prior to transfer to client.
- Accreditation: 1. Maintain current knowledge of Joint Commission and NCQA standards for program accreditation, as needed. 2. Communicates with Director about interpretation and compliance of accreditation requirements. 3. Helps prepare institution for site visits and coordinates internal review process. 4. Participates in ongoing staff education related to regulatory/credentialing requirements.
- Regulatory: 1. Coordinate credentialing staff activities in compliance with Joint Commission, NCQA, Title 22, CMS and hospital and medical staff bylaws/Credentialing Plan. 2. Monitors for changes in standards and adjusts practices accordingly. 3. Maintain current knowledge of State and Federal regulations governing medicine, dentistry, etc.
- Legal/Risk Management: 1. Maintains current knowledge of legal principles of credentialing. 2. Maintains current knowledge of State and Federal confidentiality laws affecting provider record keeping. 3. Maintains knowledge of current legal cases effecting medical staff services/credentialing/privileging decisions.
- Information Technology 1. Oversees maintenance of database on all credentialed practitioners. 2. Demonstrates competency with Microsoft Office products. 3. Use electronic mail 4. Use Internet 5. Use of medical staff credentialing software
- Fiscal/Budgetary: 1. Ensures supplies/resource utilization in cost effective manner. 2. Audits invoices for accuracy.
- Guest Relations 1. Projects cooperation and USC/hospital core values to all customer groups of assigned areas of service.
- Leadership 1. Coordinates and integrates department services on intradepartmental, interdepartmental, and client levels. 2. Plans for provision of services through provision of appropriate levels of qualified, competent staff. Policies and procedures are in place to support scope of services. 3. Establishes and maintains performance improvement and quality control activities which support the department and the hospital/client. 4. Provides for orientation, training, and continuing education of staff. 5. Monitor space/resource requirements and utilization of outside resource.
- Performs other duties as assigned.
Required Qualifications:
- Req Bachelor's degree Degree of Arts or Science in a related field
- Additional 1-2 years' experience may substitute for Bachelors Degree
- Req 3-5 years Experience with credentialing (required) in a medical staff or credentialing office
- Req Thorough knowledge of TJC, DNV, NCQA, AAAHC, Title 22, CMS standards.
Preferred Qualifications:
- Pref 2 years In a managerial role (preferred) in a medical staff or credentialing office
Required Licenses/Certifications:
- Req Certified Professional in Medical Services Management (NAMSS) Certified “Certified Professional Medical Services Management” (CPMSM) by the National Association Medical Staff Services (NAMSS) or NAMSS “Certified Provider Credentialing Specialist” (CPCS) required. (*If not certified at time of hire, must reach certification within 2 years of hire).
- Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
The annual base salary range for this position is $95,680.00 - $158,230.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.
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