General Summary of Position Responsibility:        

The Medical Staff Systems & Data Governance Manager is a non-supervisory, individual contributor responsible for the strategic administration, governance, optimization, and integrity of the organization’s medical staff, credentialing, enrollment, peer review, and Graduate Medical Education (GME) software systems.

This position serves as the subject matter expert (SME) and system administrator for provider lifecycle management technology, ensuring alignment with regulatory and accreditation standards including The Joint Commission (TJC), NCQA, CMS Conditions of Participation, and ACGME requirements. The role ensures system workflows, documentation, reporting, and data governance processes support compliance, operational excellence, and accreditation readiness across the Medical Staff Office, Enrollment Department, Peer Review, and Graduate Medical Education programs.

Essential Job Functions:

• Serve as primary system administrator for credentialing, provider lifecycle management, peer review, payer enrollment, and graduate medical education (GME) management platforms.
• Design, configure, and maintain system architecture and standardized electronic workflows supporting credentialing, privileging, reappointment, payer enrollment, performance review, and resident/fellow lifecycle processes, including development and maintenance of system documentation, configuration standards, and workflow procedures.
• Manage system security and access controls, including user roles, permissions, audit trails, and system controls to ensure compliance with organizational and regulatory standards.
• Provide system and workflow training for departmental staff to ensure consistent system utilization, adherence to standardized electronic workflows, and accurate data entry across provider lifecycle processes.
• Coordinate and lead system enhancements, upgrades, and testing in partnership with internal Information Systems/IT teams and external vendors to ensure system performance, security, and alignment with operational and regulatory requirements.
• Establish and oversee enterprise provider data governance standards, ensuring accuracy, completeness, and consistency of credentialing, enrollment, peer review, and GME data.
• Conduct routine data audits and reconciliation activities and maintain documentation demonstrating internal controls and regulatory compliance.
• Ensure systems and processes support compliance with regulatory and accreditation standards, including The Joint Commission, NCQA, CMS Conditions of Participation, and ACGME requirements.
• Develop and deliver standard and ad hoc reporting and analytics, including reporting related to OPPE/FPPE monitoring, reappointment cycles, NCQA timelines, ACGME documentation, and executive leadership dashboards.
• Collaborate with operational and program leadership to improve system utilization, identify automation opportunities, reduce manual processes, and enhance compliance and operational efficiency.
• Other job functions as assigned.

Knowledge, Skills and Abilities:

• Bachelor27s degree in Healthcare Administration, Health Information Management, Business, Information Systems, or related field preferred. Equivalent experience in medical staff systems administration, credentialing operations, data governance, and regulatory compliance will be strongly considered.
• Minimum five (5) years of experience in medical staff services, credentialing, provider enrollment, peer review, GME, or healthcare operations.
• In-depth knowledge of medical staff credentialing, privileging, reappointment, and provider enrollment processes across the provider lifecycle.
• CPCS certification strongly preferred as demonstration of advanced knowledge and expertise in credentialing standards and practices.
• Demonstrated experience administering credentialing or provider management systems, including system configuration, workflow design, reporting, and vendor coordination.
• Advanced ability to analyze provider data, conduct audits, ensure data integrity, and develop reports supporting operational, compliance, and leadership needs.
• Ability to design efficient workflows, identify automation opportunities, and improve operational processes through effective system utilization.
• Strong written and verbal communication skills with the ability to collaborate effectively across departments and serve as a subject matter expert supporting operational leaders and accreditation activities.

Education

Pay Range

At Lurie Children27s, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions.In addition to base salary, Lurie Children27s offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentivesfor select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following to learn more about our benefits.

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability
• Critical Illness, Accident and Hospital Indemnity coverage
• Tuition assistance
• Student loan servicing and support
• Adoption benefits
• Backup Childcare and Eldercare
• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
• Discount on services at Lurie Children27s facilities
• Discount purchasing program