Job Summary

The Physician Program Director for Credentialing and Privileging oversees the credentialing and privileging (C&P) of practitioners who provide care to KPGA members. Credentialing and Privileging ensures quality patient care by ensuring quality providers who practice within their scope of experience and competence. Vice-Chairs the Credentials & Privileges Committee. The ideal candidate will lead, by example by maintaining objectivity and strict confidentiality, following local and national policies and accreditation procedures with full compliance. Partners with Risk Directors to lead clinical conversations and programming pertaining to C&P.

Major Responsibilities/Essential Functions

1.Leads all Credentials & Privileging Committee meetings with KFHP, co-chairs.

2.Review credentialing and privileging files, evaluates the evidence of the qualifications of applicants and investigates issues as appropriate.

3.Serves as physician consultant for credentialing issues.

4.Partners with KFHP in making credentialing decisions and overseeing the credentialing decisions of other Credentials/Privileges committees.

5.Supports onboarding of new Department Chiefs and train them in the process of reviewing and recommending credential files.

6.Ongoing partnership with Chiefs who review and recommend credentialing files.

7.Collaborate with the physician program director of patient safety in ensuring that credentialing files contain requisite peer review information

8.In partnership with KPHP, guide the privileging process for current and future procedures that require privileging in Kaiser Permanente facilities

9.Assist and support KPHP in the credentialing and privileging of TSPMG clinicians in designated core hospitals and affiliated facilities

10.In partnership with KFHP, ensures the credentialing privileging committee is carrying out their activities in the most effective and efficient manner and continuously improving.

11.Maintains knowledge of, and research as necessary, standards including but not limited to nationally recognized standards, evidence-based standards, professional practice requirements, KP policies and procedures on Credentialing and Privileging. Leads with expertise in policies and procedures related to KPGA, KP National, and national accreditation and other similar bodies.

12.Partners with Credentialing Manager to provide oversight of Key Performance Indicator Dashboards of Credentialing activity and monitors corrective active plans.

13.Leads by example, exemplifying professionalism, impartiality, and discretion. The ideal candidate will be firm, fair, and consistent.

Job Qualifications

Minimum Education

Licensed physician with the State of Georgia License.

Board Eligible "New Graduates" in credentialed specialty when hired must become Board Certified within four years of the date of the earliest eligibility for the appropriate board to continue employment with TSPMG. Clinicians that are hospital based must follow the hospital policy for board certification requirements.

Minimum Work Experience and Qualifications

Interest in gaining experience with credentialing and privileging.

Able to balance and negotiate medical quality considerations with market need assessments.

Excellent interpersonal skills, including the ability to resolve conflicts and provide clear direction.

Demonstrated success in medical practice as a Permanente physician.

Leads efficient and effective meetings.

Demonstrates ability to work collaboratively.

Able to lead a team in executing on business objectives.

Effective presentation and communication skills

Physician applicants will need to be an active shareholder, participant or on shareholder track.

All applicants need to be in good standing with the medical group and not have any corrective action, including Clarification of Expectations or Work Improvement Plans in the past 2 years.

Preferred Work Experience and Qualifications

Prior experience with credentialing and privileging: familiar with credentialing and privileging principles

Required Licensure, Certification, Registration or Designation

Current Unrestricted License in the State of Georgia.

Board Eligible as "New Graduates" in credentialed specialty when hired. Must become Board Certified within four years of their date of their earliest eligibility for the appropriate board. Clinicians that are hospital based must follow the hospital policy for board certification requirements.

ACLS may be required depending on specialty