| Career Name | Description | City | Added | |
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Managed Care Provider Enrollment Coord.
| Job Title:
Managed Care Provider Enrollment Coord.
Job ID: 124461
Location: Burlington
Full/Part Time: Full-Time
Regular/Temporary: Regular
How To Apply
Please apply directly online at http://www.lahey.org/careers. Use the Job ID number 124461 to quickly locate the appropriate job listing. Once you have located the desired job, click on the checkbox in the 'Select' column, and then click the 'Apply Now' button, located at the bottom of the screen. Please note you are only able to select 5 jobs at a time.
02/03/2012 Managed Care Provider Enrollment Coord.
124461 Burlington
Kathleen M. Marcin
Manager, Provider Enrollment & Reporting
Lahey Clinic
41 Mall Road
Burlington, MA 01805
phone: 781-744-8085
fax: 781-744-5215
| | 2/15/2012 | Details |
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Manager, Medical Staff Office - Winchester Hospital
| Manager - Medical Staff Office
Schedule: Full-time
Shift: day shift
Hours: Monday - Friday
Job Details: Implements goals and budgets. Interview, hires, orients and manages staff of the Medical Staff Office. Oversees the processing of medical and allied health professional credentialing programs. Bachelor’s degree required. At least four years of related work experience required. At least one year of supervisory experience required. Microsoft Word, Excel, Internet, Medical terminology and credentialing knowledge required. PowerPoint and Access desired. Excellent verbal and written skills required. Knowledge of accounting, budgeting principles required.
Please apply directly at www.winchesterhospital.org | | 1/05/2012 | Details |
|
Credentialing Manager
| SENIOR WHOLE HEALTH (SWH) is a rapidly growing Medicare Advantage Special Needs Plan, pioneering the way health care is provided to low-income seniors. Our mission is to maximize the quality of life, health and independence for our Members. We are looking for a dynamic Manager, Credentialing to join our growing company in Cambridge, Massachusetts.
The Credentialing Manager is responsible for managing the credentialing team and the provider credentialing at SWH. The Candidate will act as a liaison between SWH and its delegated relationships regarding provider credentialing activity and ensures all accreditation and state and federal regulations are strictly adhered to.
Responsibilities include, but are not limited to:
• Manage the day-to-day operations of the credentialing staff.
• Develop and implement departmental policies and procedures for credentialing activities that meet accreditation, state and federal credentialing standards and regulations
• Monitor and maintain timeliness of all credentialing activity and reporting consistent with regulatory and policy requirements
• Maintain current credentialing and contracting information in the provider database
• Manage the implementation, distribution, and execution of provider/vendor contracts
• Troubleshoot all credentialing and database issues
• Perform credentialing audits as needed
Qualifications:
• Bachelor degree desired, High School Diploma or equivalent required
• 3-5 years experience working in provider credentialing with knowledge of NCQA requirements
• Previous supervisory experience preferred
• Proficiency in using Microsoft Office Products
We offer a competitive salary and excellent benefits.
Please forward resumes to hr@seniorwholehealth.com or fax to (617) 252-6303.
| Cambridge | 2/02/2012 | Details |
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Medical Staff Coordinator - DFCI
|
JOB DESCRIPTION
JOB TITLE: Medical Staff Coordinator
JOB CODE:
GRADE:
FLSA STATUS:
DEPARTMENT:
EFFECTIVE/UPDATE DATE:
____________________________________________________________________________
GENERAL SUMMARY: Responsible for coordination and preparation of medical staff functions; prepares for committee meetings, takes minutes, processes and distributes appropriate correspondence. Works under the supervision of the Office of Medical Affairs and Professional Credentialing manager. The coordinator assists with the development, planning and implementation of the credentialing/privileging process. Assists in compliance with the accrediting and regulatory agencies (i.e. TJC, CMS, NCQA, etc.) in regard to credentialing while developing and maintaining a working knowledge of the statutes and laws. Ensures that all expirables are reviewed, obtained, and managed on a monthly basis according to rules and policies. Maintains the confidentiality of all business/work and medical staff information. Assists in managing the flow of information between the OMAPC team, Credentials, MSEC, Board committee members, Medical Staff Leadership (including the Department Chairs and Program Administrators). Assists in identifying, establishing, and fulfilling goals and objectives consistent with overall strategic goals. Other related administrative duties as assigned.
____________________________________________________________________________
PRIMARY DUTIES AND RESPONSIBILITIES:
1. Processing initial and reappointment applications to the Medical Staff.
2. Entering and maintaining up-to date data for each applicant in the database.
3. Ensures that all expirables are reviewed, obtained, verified when necessary, managed according to departmental specifications.
4. Committee support including the timely preparation of agendas, minutes, supporting communication and follow-up.
5. Ensures compliance with Medical Staff Bylaws, Rules and Regulations, regulatory/accrediting agencies as they relate to the Medical Staff.
SUPERVISORY RESPONSIBILITIES: None
MINIMUM JOB QUALIFICATIONS:
1. Bachelor’s degree or equivalent experience.
2. Three years experience in medical staff services/provider credentialing.
3. CPCS and/or CPMSM preferred.
KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:
1. Working knowledge of MSOW software preferred.
2. Working knowledge of Microsoft office software
3. Ability to organize/prioritize workload with minimal supervision.
4. Excellent written and verbal communication skills.
PATIENT CONTACT: None
WORKING CONDITIONS:
Standard office environment.
DISCLAIMER: (THIS WILL REMAIN FOR ALL JOB DESCRIPTIONS)
The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Requirements are subject to possible modification to reasonably accommodate qualified individuals with disabilities. This document does not create an employment contract, implied or otherwise, other than an “at will” employment relationship.
APPROVALS:
_____________________ ________ ____________________ ________
Compensation Date Manager Date
| | 2/08/2012 | Details |
|
Medical Staff Coordinator - Marlborough Hospital
| I. PURPOSE & PRIMARY FUNCTIONS
Coordinates activities and functions relating to the Medical Staff of the Hospital under the supervision of the Vice President of Medical Affairs.
II. POSITION QUALIFICATIONS
1. Licensure/Certification/ Registration:
• Certified Medical Staff Coordinator, (CPMSM) preferred
2. Education:
• Associate’s degree, preferred.
3. Other Qualifications:
• Proven excellent interpersonal and communication skills.
• Ability to maintain confidentiality.
• Proven collaboration skills with other disciplines.
• Proven excellent organizational skills.
• Demonstrated ability to establish and maintain relationships with physicians and allied health professionals.
• Knowledge of State and Federal laws re: credentialing regulations, preferred.
• Knowledge of Joint Commission standards, preferred.
• Demonstrated computer and word processing skills.
III. MACHINERY, TOOLS & EQUIPMENT
Normal business office equipment including telephone, fax machine, photocopy machine, answering machine/voice mail, computer and printer.
IV. WORKING RELATIONSHIPS
• Reports to: VP of Medical Affairs
• Provides supervision to:
• Works in collaboration with: Credentialing specialists, office affiliates, physicians, allied health professionals as well as outside credentialing review agencies, other affiliated members of our system, and various department liaisons.
• Direct contact with the following age groups:
_ 0-11m _ 1-3y _ 3-5y _ 6-11y _ 12-17
_ 18-45y _ 45-59y _ 59-79y _ >80y X N/A
This position will have the following access level to patient health information:
No PHI _ Limited PHI X Broad PHI _
V. WORKING CONDITIONS
Physical Demands: See attached checklist
VI. DUTIES & RESPONSIBILITIES
1. Communications and Teamwork: Demonstrates a commitment to maintain effective communications with all health team members and with all Hospital customers to facilitate and promote effective working relationships, customer service and patient satisfaction.
1.1 Demonstrates professional and courteous behavior to staff, patients and others and introduces self to visitors/patients. Wears ID badge 100% of time while working.
1.2 Communicates information clearly to patients, visitors and co-workers in both verbal and written form and documents information clearly and completely
1.3 Displays, through conduct and performance, an attitude, which reflects the respectful treatment of others, a commitment to teamwork and commitment to the Hospital’s mission, values and goals. Participates in all appropriate ways to attend to the needs of all patients and visitors.
1.4 Actively participates in department-specific and/or interdisciplinary performance improvement and able to articulate performance improvement initiatives.
2. Work Practices: Demonstrates a commitment to maintain work practices that comply with established Hospital policy
2.1 Observes and respects the personal privacy and confidentiality of information regarding patients, visitors, physicians, applicants and co-workers.
2.2 Maintains regular work attendance and is available for work as scheduled
2.3 Dresses in a professional, business-like manner, reflecting the Hospital’s dress policy and the need to be responsive to the perceptions of patients and visitors.
2.4 Attends and completes all mandatory education and information sessions
2.5 Maintains current certification, licenses, registrations, etc. as required by the position
2.6 Willingly provides assistance to others when requested and accepts other job-related duties as assigned.
2.7 Equally shares responsibility for overtime, rotation, etc. and any necessary schedule changes
2.8 Attends departmental staff meetings on a regular basis and takes responsibility for becoming knowledgeable of meeting content if not attended.
3. Safety: Demonstrates a commitment to promote a safe environment for patients, visitors and peers.
3.1 Utilizes proper body mechanics, universal precautions, etc. in the work environment
3.2 Remains knowledgeable regarding the utilization of emergency response in fire, code or disaster situations
3.3 Identifies unsafe conditions in the work environment and takes appropriate actions to reduce/eliminate risk; reports all incidents that put the environment, patients, visitors or staff at risk.
3.4 Understands importance of patient safety issues and initiates appropriate action to address.
4. Professional Competency: Demonstrates a commitment to maintain competencies and participate in those activities which contribute to the on-going development of self and others.
4.1 Accomplished all goals and objectives identified in prior year’s performance assessment meeting
4.2 Incorporates knowledge regarding the growth, development, physical, emotional and cultural needs of the populations served.
4.3 Applies all applicable Hospital and departmental standards when planning and providing care or a service.
4.4 Consistently produces high quality work with a minimum of errors. Maintains a high level of productivity and seeks ways to assist others when/if work is completed.
4.5 Demonstrates autonomy, initiative, professionalism and an ability and willingness to problem-solve.
4.6 Assumes responsibility for own continuing education and learning and suggests to Director/Senior Manager the means to accomplish it.
4.7 Participates, as requested, in orienting and mentoring other staff.
5. Maintains current and updated Medical Staff bylaws and relevant hospital policies.
5.1 Maintains and updates Medical Staff rules, regulations and bylaws.
5.2 Facilitates Medical Staff approval process for policies and forms that involve Medical Staff practice.
5.3 Maintains and revises credentialing manual and incorporates amendments.
6. Coordinates and meets all requirements of the Mass. Medical Society’s accreditation for Continuing Medical Education (CME).
6.1 Schedules qualified speakers for identified topics.
6.2 Maintains CME database for the Medical Staff members.
6.3 In conjunction with Director of Medical Education, prepares application for accreditation and required reports.
7. Maintains confidential minutes, agendas and related materials pertaining to all activities of the Medical Staff. Provides follow-up to action items.
8. Liaison for the Medical Staff computer software.
9. Cross trains with Sr. Coordinator to learn all aspects of OPPE/FPPE
10. Coordinates physician orientation for new Medical Staff members.
11. Coordinates, develops and maintains physician on-call schedule for emergency coverage.
12. Assists with projects regarding the Medical Staff.
13. Performs other duties as assigned by the Vice President of Medical Affairs.
14. Coordinates physical/diagnosis sessions under the direction of the Director of Continuing Medical Education.
15. Monitor provisional staff providers and transition to regular staff members at the one year mark.
16. Maintain QA file and provide Risk Manager with the monthly data that is needed to complete the physician profile.
17. Scanning and updating the Echo database with the updated documents.
18. Updating and maintaining delineation of privileges.
19. Send QA information to physicians at time of reappointment.
20. Send approval letters to physicians after board approval.
21. Check for sanctions with the Office of Inspector General for all practitioners monthly.
22. Create maintain and distribute monthly Medical Staff meeting calendar.
23. Meeting attendance entry in echo database. This goes along with minutes.
24. Maintain and file hard copies of meeting minutes.
25. Maintain medical staff email distribution list.
26. Send out notification of privileges and resignations after board approval.
27. Resignation letters sent to resigning physicians.
28. Create flyers for upcoming events.
29. Maintain committee assignments.
30. Request from other departments for lists with various physician information.
31. Doctors functions preparations. Quarterly Staff, Doctor’s Day, etc.
32. Criminal Background Check.
33. National Practitioners Data Back Check.
Tiffany L. Caputo
Medical Staff Coordinator
Medical Staff Administration
Marlborough Hospital
157 Union Street
Marlborough, MA 01752
Main Office Line 508-486-5435
Dircect Line 508-486-5434
Fax. 508-485-9172
email: tiffany.caputo@umassmemorial.org
| | 2/08/2012 | Details |
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