Medical Staff Service Coordinator - Remote Must Reside in North Carolina at Duke Health

Durham, North Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

26 Jun, 26

Salary

0.0

Posted On

28 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Privileging, Quality Control, Database Management, Regulatory Compliance, Accreditation Compliance, Data Entry, Application Processing, Re-credentialing, Policy Interpretation, Committee Support, Leadership, Communication, Coordination, File Maintenance, Reporting

Industry

Hospitals and Health Care

Description

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. General Description of the Job Class Under the supervision of the Hospital Manager of Medical Staff Services/DUHS CVO, the Medical Staff Services Coordinator is responsible for coordination of aspects of DUHS Medical Staff Services office by providing essential verification and quality control functions to support DUHS's goals for credentialing and privileging health care providers while ensuring adherence to legal, regulatory, and delegated requirements. Assignments are planned and executed with considerable independence in compliance with established policies and procedures, bylaws, regulations and laws. Duties and Responsibilities of this Level Organizing and directing of a comprehensive and specialized credentialing program to assure continued accreditation compliance by the Joint Commission, NCQA, and AAAHC, as well as any other regulatory organizations. Interpretation, explanation and following all regulatory guidelines, including medical staff bylaws, fair hearing plan, rules and regulations and policies. Maintaining accuracy in the Credentialing database to identify (and disseminate to others), medical staff members and their clinical privileges; prepares and maintains other related records and reports. Responsible for the accuracy and integrity of the credentialing and privileging database system and for data entry performed in the medical staff office. Receives application/reappointment application from the CVO, oversees the completion of the credentialing process for medical, professional, and advanced practice professional staff and granting of clinical privileges/scopes practice for the DUHS Medical Staff. Coordinating, monitoring and maintaining the credentialing and re- credentialing process. For reappointment applications, this includes gathering of additional data for incorporation into hospital-specific processes (i.e., QI elements, FPPE/OPPE process, etc.) and evaluation/analysis of confidential healthcare provider credentials for the initial appointment and reappointment processes prior to presentation for the Department Chair, Division Chief, and Credentials Committee review and action. Works with medical staff leadership and hospital clinical staff for the approval and ongoing review of credentialed practitioners. Monitoring and revising credentialing and privileging/scope of practice forms as needed. Ensures maintenance of medical staff, advanced practice professional staff, and professional staff files. Scheduling and supporting (prepares agenda, attends and prepares minutes) the Credentials Committee. Provides support to the Credentials Committee chair as needed. May participate on other Hospital committees as requested. Uses discretion to escalate identified red flags to the Manager, Medical Staff Services/CVO Office. Communicating medical staff information to appropriate departments; including approval notices to the provider, and other entities (if applicable). In addition, prepares reports to the respective boards to comply with their deadlines. Demonstrates effective leadership skills and coordination of intra- department activities and inter-department integration. Assures necessary revisions are communicated with the Manager, Medical Staff Services/CVO Office for the ongoing development and implementation of policies and procedures that guide and support the provision of services. May develop and facilitate the medical staff orientation, as well as other on-boarding activities, as requested by the Manager, Medical Staff Services/CVO Office. Perform other related duties incidental to the work described herein. Minimum Qualifications Education Work requires analytical, communications and organizational skills generally acquired through completion of a bachelor's degree program. In lieu of bachelor's degree, four years relevant experience in Managed Care or Medical Staff Credentialing/Privileging (in addition to the experience requirement for the role) Experience One year of experience in a Medical Staff/Managed Care credentialing office Degrees, Licensure, and/or Certification Certification by NAMSS (CPMSM or CPCS) strongly preferred Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Responsibilities

The coordinator manages essential verification and quality control functions for the Medical Staff Services office, supporting credentialing and privileging goals while ensuring adherence to legal and regulatory requirements. This involves organizing a comprehensive credentialing program, maintaining database accuracy, and overseeing the application and reappointment processes for various professional staff.