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   Current UPMC employees must apply in HR Direct

Medical Staff Coordinator

Description

Coordinate the credentialing process for initial appointment and reappointment for the medical and allied health professional staff. Manage the compliance to ensure all individuals with clinical privileges provide services within the scope of their training, licensure and individual clinical privileges granted.

Responsibilities:

  • Coordinate the credentialing process for initial appointment and reappointment for the medical and allied health professional staff.
  • Critically review primary source verification (psv) scanned documents to determine any incorrect, omitted or discrepancies in data entry and psv requests.
  • Identify any issues in file red flags requiring further review.
  • Obtain quantitative and qualitative data for practitioners in the credentialing process either from applicant (initial appointments), internal databases (reappointments - Impromptu/Corporate Database) or from practitioner's primary facility.
  • Ensure complete and accurate credentialing information is provided to chiefs and chairpersons to enable them to make informed decisions regarding clinical privilege delineation.
  • Implement process for re-credentialing of physicians and allied health professionals to the medical staff to adhere to regulatory standards.
  • Maintain knowledge of latest recommendations for the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), National Commission on Quality Assurance (NCQA) the State Medical Society, and other state requirements particularly with reference to accreditation standards.
  • Forward appropriate individuals and callers to Director as required.
  • Prepare and disseminate invitations, track responses, create seating arrangements, for review and approval, select and retain entertainment, purchase gifts and prizes, and checking-in invited guests at events as necessary.Initiate any additional psv required per established policies and procedures.
  • Proactively obtain supporting documentation to support requests for privileges by developing contacts with other facilities and medical leaders.
  • Ensure data is entered into facility areas of credentialing system following board approved credentialing actions.
  • Assist with the coordination of Medical Staff social activities.
  • Compare psv, curriculum vitae and credentialing information form.
  • Upon receipt of completed hospital-specific packets, initiates data collection and compilation from Centralized Verification Office (CVO).
  • Validate data monthly to assure accuracy.
  • Provide support to the Medical Staff Officers, Committee Chairmen and members, and other healthcare professionals in the development of mechanisms to assess physician performance, identify potential risks, and document disciplinary action throughout the credentialing process - initial appointment and reappointment.
  • Review and correct, if applicable, data entered by the CVO. Notify CVO of discrepancies or errors.
  • Maintain credentialing schedules and status reports for practitioners in the credentialing process.
  • Create physician profile for quick reference by medical staff leadership.
  • Obtain any additional information requested.
  • Maintain and coordinate facility-specific data entry for physician database to reflect credentialing actions.
  • Maintain a working knowledge of the Hospital Bylaws, General Rules and Regulations, Medical Staff Bylaws, General Rules and Regulations and Department Rules and Regulations.
  • Coordinate and facilitate both the informal and formal credentialing peer review/recommendation process per established policies and procedures.
  • Forward and track complete files to Division Chiefs and Department Chairmen for approval.
  • Adhere to departmental time frames for file completion.
  • Compile and create practitioner files including all pertinent information in accordance with departmental policies.
  • Answer phones/screen visitors.
  • Closely monitor information collection; cognitive analysis of information received; evaluate adequacy and quality of information.
  • Forward approved files to credentials Committee for review and approval.
  • Pursue additional information independently, if necessary, for effective and comprehensive peer review decision-making.
  • Immediately report to Director any problems noted with applicants' credentials as identified by principles involved in the information collection process.
  • Primary responsibility for performing the mandated queries for practitioners in the credentialing process (initial and reappointments) with the National Practitioner Data Bank.
  • Provide informational emails/mailings to facility departments information updates regarding approved credentialing actions.
  • Maintain close communication and develop working relationships with the Centralized Verification Office, department enrollment specialists, medical staff officers, department chairmen and committee chairmen to ensure expeditious flow of recommendations for timely credentialing through the medical staff committee and Board review and approval process.
  • Adhere to all policies and procedures regarding mandated queries and reporting mechanisms and monitors, on an on-going basis, the financial account with the data bank to ensure compliance and accuracy.
  • Develop and maintain working relationships with chiefs, chairman, nursing staff, ancillary departments, etc. to proactively provide information regarding practitioner privileges or scope of practice and credentialing actions.
  • Inform CVO of incorrect data entry and/or missing psv.
  • Assists in maintaining confidential credentials and administrative files on all Medical Staff members, reflecting current status, i.e. category, board certification, privileges, attendance records, continuing medical education activities, health
  • Timely notification of medical staff and appropriate Hospital departments to avoid overlaps of major activities.
  • Maintains current financial information for the Secretary/Treasurer.
  • Updates files on an ongoing basis.
  • Adheres to time schedule.
  • Utilizes meetings with Director, Medical Staff Office to seek direction and report progress, problems and results of ongoing activities.
  • Performs other related duties as assigned by authorized personnel including those for emergency situations.
  • Provides secretarial support for Medical Staff department and committee meetings as directed by the Director, Medical Staff Office
  • Provides clerical assistance related to the filing, maintenance, and retrieval of information relevant to all aspects of the position responsibilities.
  • Maintains accurate attendance records for all departmental, committee and Medical Staff meetings.
  • Supervises scheduling and maintenance of a master calendar for Medical Staff and Hospital activities and the proper notification of such activities as directed by the Director, Medical Staff Office.
  • Maintains mailboxes, supplies, equipment, posting of meeting notices and pertinent information in the medical staff lounge.
  • Informs appropriate individuals via copy of the minutes of action items and policy changes to assure expeditious follow through.
  • Is conscientious regarding use of ill and absent time.
  • Compiles statistical information for surveys, etc.
  • Maintains Committee, Department, and Medical Staff Minutes for utilization by appropriate Medical Staff members and hospital personnel.
  • Distributes Medical Staff coverage notices as necessary.
  • Assures room reservations, dietary arrangements, housekeeping arrangements and parking arrangements when indicated.
  • Assists to coordinate the Annual Medical Staff Outing and social functions.
  • Maintains a current master copy of Medical Staff, Departmental, Committee and Specialty Rosters
  • Provides clerical assistance related to the filing, maintenance, and retrieval of information relevant to all aspects of the position responsibilities.
  • Assumes other related responsibilities as assigned and may perform duties related to Administration.
  • Transcribes meeting minutes within 72 hours of the meeting or within 72 hours of receiving the Chairman's minutes.
  • Provides supportive services to the Medical Staff officers in fulfilling the responsibility of their offices as directed by the Director, Medical Staff Office.
  • Responds to constructive criticism.
  • Assists in all aspects of credentialing and in re-credentialing (reappointment) the Medical Staff and Mid-Level Providers.
  • Annual notification of medical staff dues payments. Assures continuity of Medical Staff activities when officers change.
  • Accepts high degree of responsibility for own actions.
  • Maintains the status, university affiliation, committee participation, results of quality assessment activities, publications, licensing, DEA registration, and evidence of current malpractice coverage.
  • Posts notices of meetings on a monthly basis in Medical Staff Lounge.
  • Exhibits a high degree of responsibility for confidential matters.
  • Attends professional meetings to maintain knowledge of current and future trends in coordinating the Medical Staff Office.
  • Performs administrative duties in assisting the Medical Staff. As a resource person, is knowledgeable of current accreditation standards and legal requirements related to medical staff organization, alerting the appropriate body regarding change.
  • Assists in maintaining a current Physician Guide by Specialty-
  • Types and distributes letters, memos and other correspondence.
  • Establishes and maintains filing mechanisms to facilitate timely retrieval of information.
  • Distributes revisions, etc. to appropriate Medical Staff members and hospital departments or as requested. Updates on an ongoing basis and distributes at least annually as necessary.
  • Collaborates with appropriate medical staff to assure compliance with accreditation standards.
  • Prepares the President's Reports to the Board of Directors.

 

Qualifications

  • Associate's or B.S. degree in Business or Healthcare Administration is preferred; however, 3 years experience may be substituted for a degree.
  • Direct experience in Medical Staff Services preferred.


Licensure, Certifications, and Clearances:
CPMSM (Certified Professional Medical Services Management) or Certified Provider Credentialing Specialist (CPCS) Certification by the National Association for Medical Staff Services preferred.
 

  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct