System Director, Medical Staff Services, Credentialing And Provider Enrollment – University Hospitals Retained Search

University Hospitals (UH) has retained Summit Talent Group to conduct a national search for the System Director, Medical Staff Services, Credentialing and Provider Enrollment.

This is the most senior system role in medical staff services, reporting to the Chief Operating Officer for UH Clinical Network and overseeing a team of four managers with a total of 50 FTEs. As the most senior system level Medical Staff professional, this highly visible leader will be instrumental in the continued evolution to a fully standardized, efficient CVO to support approximately 5,400 providers across the four UH markets.

The System Director will bring a refined skill set to the role in the areas of relationship building, communication, and continuous process improvement as well as a track record of working in partnership with physicians and providers. Moreover, the incumbent will be both a change agent and a team builder, adept at engaging and mentoring the staff as well as being a champion of service excellence.

This is a tremendous opportunity for a strategy-focused medical staff services professional to create an operationally successful CVO with exceptional outcomes through high-reliability and by partnering with all relevant internal and external stakeholders.

Position Summary/Essential Duties:

• Directs, plans, organizes, and manages the activities of UH’s system-wide Medical Staff Services, Credentialing and Provider Enrollment department for all wholly owned hospitals, ASCs and PCVO, including budget management and staff.
• Accountable for the strategic direction and operational accountability for department to include MSOW data management, FPPE/OPPE, and payor delegation.
• Responsible for Enterprise Information Systems and act as project manager for implementation of new computer modules/components.
• Responsible for the preparation, organization and follow-up involved in maintaining hospital compliance with all relevant standards, regulations and statutes including, but not limited to TJC, NCQA, URAC, CMS, ORC, and ODM.
• Facilitates negotiation of delegated agreements and successful completion of audits with payor partners. Ensures delegated functions are being executed according to contractual terms while also maintaining compliance with accrediting body standards and all State and Federal regulations. Oversee the implementation of corrective action plans if non-compliant.
• Guide the development of the overall leadership structure and strategy plan, create goals and plans for quality and financial management of the medical staff/credentialing/provider enrollment department system wide.
• Plans, formulates, and recommends for approval policies, procedures, programs, and other strategies which will further the objectives and requirements of department (i.e., takes initiative in planning and formulating strategies and plans). Processes and procedures are effective, efficient, and aligned with organizational goals and values.
• Provides leadership, direction, process improvement models & initiatives and establishes evidence based, best practice analysis to improve/establish work standards for UH initiatives.
• Identify, develop, and implement strategies and long-term vision for increasing efficiency of the department with a defined focus on workflow optimization.
• Establishes performance standards with which to measure effectiveness and efficiency of services.
• Responsible for recruiting, training, mentoring, evaluating, and disciplining departmental staff.
• Works with leadership and medical staff to identify and evaluate programs and emerging technologies.

Qualifications:

• Bachelor’s Degree required; master’s degree preferred.
• Minimum of 10 years management experience in medical staff services/credentialing in a healthcare setting; experience with the functions performed in a Centralized Verification Organization and with provider enrollment. Extensive knowledge of regulatory standards to include NCQA and TJC as well as state and federal regulations related to credentialing.
• Minimum 7 years in a leadership position.
• Certified Professional Medical Services Management (CPMSM) required; additional certification in Certified Provider Credentialing Specialist (CPCS) is preferred.

For additional information on this position please contact us.