VCU Health System's Medical Director Administration is seeking a full time Department Director. This person provides leadership to VCUHS Medical Staff Services by developing, organizing and overseeing the operations of VCUHS clinical privileging/credentialing, provider enrollment and meeting the Health System's requirements for Medical Staff Appointment and Provider Insurance Credentialing by JCAHO, NCQA and relevant state and federal standards and guidelines.
- Contributes to the provision of superior service related to credentialing health care providers who provide services to patients at MCVH of VCUHS. Identifies and reduces lost revenue due to untimely practitioner enrollment. Influences and promotes quality standards for the administrative management of healthcare professionals.
- Takes accountability, uses initiative, takes risks, thinks strategically, possesses critical thinking skills, promotes change, uses good judgment, seeks guidance as needed and serves as a mentor, and inspires and motivates others.
- Controls and directs the administrative support of governance documents. Ensures that all documents are compliant and current. Protects permanent records by managing a secure record retention process.
- Directs meeting activities (e.g. agenda development, documentation, follow-up, communication).
- Provides guidance on accreditation, regulatory issues, medico-legal implications, national standards of care, best practices, meeting outcomes and resolution.
- Works with the VCU School of Medicine and Dentistry and the Clinical Departments to provide for an efficient and effective credentialing and privileging process that results in the timely appointment of medical staff to the VCU Health System.
- Establishes standards and analyzes work procedures that promote best practices and champions innovation.
- Establishes and maintains a medical staff orientation program in coordination with clinical departments and VCU School of Medicine and Dentistry.
- Cultivates positive interpersonal relationships with the members of the Medical Staff, Medical Staff Leaders, and Administrative and Ancillary staff.
- Incorporates software programs and technology in all operational functions.
- Oversees and manages diverse and comprehensive systems and functions (credentialing, privileging, meeting management performance improvement, database management, governance, regulatory compliance, leadership development and operating processes) performed in the Medical Staff Services Department.
- Works with payers to create an efficient, effective process for enrolling medical staff with Health System government and managed care plans.
- Maintains continuous compliance with all applicable regulations including but not limited to JCAHO, CMS, and NCQA.
- Identifies and develops programs to meet the needs of medical staff and foster strong working relationships between medical staff and Health System.
- Analyzes data, makes recommendations and implements plans.
- Directs 8.0 FTE within provider enrollment and credentialing units.
- Directs and manages the strategic and daily activities of the department.
- Bachelor’s Degree in Healthcare Administration or a health care related field from an accredited program
- Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) by the National Association Medical Staff Services (NAMSS)
- Minimum of five (5) years of experience in hospital medical staff credentialing.
- Minimum of five (5) years’ experience in provider enrollment in Medicare, Medicaid and managed care plans.
- Five (5) years in industry setting (MSO, CVO, MCO).
- Previous work experience with the application of JCAHO, NCQA, State and Federal guidelines relative to medical staff credentialing/ provider enrollment.
- Minimum of three (3) years in a supervisory/management position.
- Master's Degree in Healthcare Administration or a health care related field from an accredited program
- Dual CPMSM and CPCS certifications
- Seven (7) years of experience in hospital medical staff credentialing and provider enrollment for managed care and government healthcare plans.
- Previous work experience with JCAHO, NCQA, URAC, CMS, State and Federal guidelines relative to medical staff credentialing/provider enrollment.
- Five (5) years in supervisory/management role.
At VCU Health System, our most important assets are not bricks and mortar; they are our team members … all 11,000+ of them. Our workforce is diverse, dedicated and talented. Our team members continue to earn local, regional and national awards and accolades, which is an indicator that they are happy and feel supported working here. And our culture of STAR Service focuses on our common purpose – “Our Caring Service Begins With Me.” – in the provision of the highest level of customer service, which encourages diversity and inclusion.
If you have been looking to take your career to the next level, we have been looking for you.
We offer more than 400 work/life benefits including competitive pay, generous benefits, flexible work options, prepaid tuition, on-site child and elder care and much, much more.
For a full position description and to apply visit HERE
EOE M/F/Vets/Disabled. VCUHS appreciates diversity and encourages women, minorities, veterans and persons with disabilities to apply.