Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:
Regular

Time Type:
Full time

Scheduled Weekly Hours:
40

Department:
910397 URMC Medical Staff Services

Work Shift:
UR - Day (United States of America)

Range:
UR URG 115

Compensation Range:
$97,400.00 - $146,000.00

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

The IT Manager of Medical Staff Services Information Systems oversees and directs the administration, maintenance, and support of enterprise-wide provider credentialing, privileging and payer enrollment software applications. Plans, develops, and directs University of Rochester Medicine activities related to the development, implementation, and maintenance of provider credentialing, privileging, and payer enrollment applications. Ensures seamless integration of provider data with eRecord EHR and other enterprise systems to support operational efficiency, regulatory compliance, and high-quality patient care. Drives initiatives that improve data integrity, enhance provider lifecycle management, and optimize credentialing and payer enrollment workflows, ensuring a seamless and compliant provider experience across UR Medicine.

Responsible for ensuring optimal performance, reliability, and security of application systems. Leads the team in implementing application enhancements, troubleshooting issues, and providing technical support. Manages application lifecycle activities, including planning, deployment, and retirement. Oversees resource allocation, budgeting, and staff development within the application administration function.

ESSENTIAL FUNCTIONS
Daily Operations:

• Manages and oversees daily operations and ongoing maintenance of provider credentialing and payer enrollment applications to ensure uninterrupted business processes.
• Leads the development and implementation of provider credentialing and enrollment solutions aligned with the University's strategic goals. Conducts in-depth analysis of application performance and user needs to identify opportunities for improvement. Develops and communicates comprehensive reports on application status, performance metrics, and recommendations.
• Drives innovation in provider credentialing, privileging and payer enrollment.
• Responsible for improving upon entire systems or processes using significant conceptualization, reasoning and interpretation skills.
• Collaborates with credentialing software and other vendors on credentialing, privileging and payer enrollment initiatives.

Information security, compliance and regulatory oversight:

• Collaborates with internal and external customers, vendors and stakeholders (i.e. ISD, privacy officer, HR, compliance, etc.) to meet business and operational needs, resolves issues, and ensure integrity and security of assigned applications and provider data.
• Works directly with the Information Systems Division to facilitate risk assessment and risk management processes.
• Ensures system functionality is in continuous compliance with accreditation and regulatory standards of The Joint Commission TJC, Center for Medicaid and Medicare Services (CMS), National Committee for Quality Assurance (NCQA), State Department of Health, Occupational Health and Safety Association (OSHA), Delegated Commercial Payers and other regulatory agencies that govern healthcare.
• Participates in meetings and committees: Credentials and Privilege Review Committee (CPRC), and others as requested.
• Stay updated on changes in healthcare regulations and accreditation standards, leading IT and data management-related adjustments to maintain compliance.

Quality assurance and data analytics:

• Develops and implements data-driven performance metrics and key performance indicators (KPIs) to assess the quality and efficiency of the credentialing process and data management.
• Utilizes data analytics to drive quality improvement initiatives, reduce errors, and optimize the IT-powered credentialing process and provider data management.

Reporting and documentation:

• Generates, analyzes, and reports on data related to provider credentialing activities and data management, and communicate findings to leadership.
• Maintains precise and comprehensive records of credentialing activities and provider data management, with a focus on data security and IT documentation.

Team leadership:

• Manages an IT team in support of execution technology operations and projects across URM, including affiliates across the region.
• Directs the performance evaluation process for the Medical Staff Office Information Technology support staff.
• Leads career development efforts for direct reports. Provides coaching/mentoring to standardize best practices across all team activities.

Other duties as assigned.

MINIMUM EDUCATION & EXPERIENCE

• Bachelor's degree required in Information Technology, Information Systems, Computer Science, Health Information Management, or a closely related field preferred
• and 5 years of relevant healthcare application, provider-data, or credentialing-system experience required
• Or equivalent combination of education and experience
• Experience in an academic medical center, health care system or higher education preferred

KNOWLEDGE, SKILLS AND ABILITIES

• Strong verbal and written communication skills, with the ability to create clear, concise and prompt communications required
• Strong follow-through skills, with the ability to manage multiple initiatives simultaneously required
• Exhibits managerial courage. Willing to take calculated risks and to speak up for the best interests of the team required
• Ability to communicate effectively at all levels of the organization, including with executives, physicians, and nurses, with the ability to discuss technical information in a meaningful way with persons of varying levels of expertise preferred
• Experience with project management from planning through implementation preferred.
• Experience with relational database management and development, and ETL (extract, transfer, load) database process preferred.
• Previous experience and with The Joint Commission, CMS and other healthcare regulatory agencies preferred.
• Experience in an academic medical center, health care system or higher education preferred.