Job Summary and QualificationsJob Summary and Qualifications
Responsible for managing, coordinating and monitoring the medical staff services functions including credentialing, quality management profiles and continuing education as appropriate. Collaborates and coordinates with Medical Staff leaders and administrative representatives. Ensures effective use of resources and staff. Functions as a member of the team to assure optimum performance of the delegation of credentialing and relevant data integrity of applicable information systems databases.
Essential Job Functions:
- Develops, implements and evaluates application processes for medical staff membership and clinical privileges for physicians and other health care providers to ensure cost-effectiveness and timelines of services.
- Oversees Medical Staff minutes and quality improvement data/documentation in an effort to limit legal exposures and assure compliance with TJC procedures.
- Maintains knowledge of and ensures adherence to Federal and State regulations and accrediting body standards for issues related to the organized Medical Staff and the credentialing process.
- Provides guidance, and serves as an expert resource to the Medical Staff organizations and Methodist Healthcare System hospitals.
- Interprets Medical Staff Bylaws, applicable laws, State and Federal regulations, and TJC requirements to the Medical Staff. Analyzes processes and recommends and implements changes to improve operations, foster communication, ensure continuity in services provided as well as consistency in documents, policies, and procedures.
- Plans, formulates, and recommends for approval of the MEC the policies, procedures, programs, and other strategies which will further the objectives and requirements of the Medical Staff Office.
- Coordinates and maintains governance documents, such as Medical Staff Bylaws, Rules and Regulations, and related documents, as well as policies and procedures of the Medical Staff Office.
- Assures that there is a review of existing policies and governance documents on a regular basis and recommends changes to the MEC as appropriate.
- Maintains open communication with department on a regular basis and assist peers in ensuring compliance with credentialing and privileging requirements.
- Carries out specific tasks assigned by the MEC, Chief of Staff, and/or Chief Executive Officer.
What qualifications you will need:- Bachelor's degree in Business, Health Care Administration, or related field and three (3) years increasingly responsible experience in hospital and/or healthcare credentialing; or Associate's degree in Business, Health Care Administration, or related field and five (5) years in the specific work area included in the essential functions of the job; or Eight (8) years in the specific work area included in the essential functions of the job Working knowledge of state and federal laws relating to due process and provisions of the Health Insurance Portability and Accountability Act of 1996 and TJC standards.
- Basic knowledge of anatomy and physiology, medical terminology and functions of medical staff.
- Advanced computer skills in word processing, spread sheets and databases. Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable). Preferred: Minimum License, Certificates, or Registrations Required:
- Required: Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) or obtain such within 12 months of hire.
**Current and new incumbents hired prior to 07/31/2028 will have until 07/31/2029 to obtain.**Benefits Methodist Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
- Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
- Wellbeing support, including free counseling and referral services
- Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
- Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
- Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
- Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location. 
