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Associate Director, Credentialing, Healthcare Improvement

New York City Health and Hospitals Corporation

Job Description

Empower Every New Yorker — Without Exception — to Live the Healthiest Life Possible



Come join the largest public hospital system in the nation! Every day, we work together to make an extraordinary difference in the health and well-being of each individual we serve without exception. Join our team and help us create a positive patient experience.



NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.


 


Responsibilities:


Associate Director acts as liaison between Centralized Credentialing Office to Facility credentialing committees, physicians and medical staff department members to ensure that all aspects of credentialing/regulatory compliance issues with state and regulatory agencies are monitored;  that bylaw development and updates for all levels of healthcare services specially to cross credentialing of clinicians on all levels is adhere to; ensures that  medical staff credentialing is acted upon in a consistent and timely manner; and may oversee other Credentialing Specialists. 


Responsibilities include but are not limited to:



•          May be responsible to gather information and perform research in credentialing disputes under the direction of the Management.



•         Researches incidents, submission of applications for timely processing, and request appropriate follow-up information from facility Medical Staff Office or other sources as indicated.



•         Monitors and maintains the standards of The Joint Commission (TJC), the National Committee for Quality Assurance (NCQA), the Medical Staff Bylaws, Rules and Regulations and all other applicable regulatory requirements to ensure Centralize Credentialing compliance.



•         Coordinates the timely processing of all activities of initial and reappointment applications for completeness and in accordance with appropriate standards relative to the organizations Credentialing Manual. Provides credentialing support to the credentialing managers and supervisory support to the credentialing specialists. Maintains a sound working knowledge of credentialing and provides consultation to the Network regarding credentialing, to ensure all processes are in compliance with state statutes and regulatory agencies as demonstrated by observation.



•         Communicates with Medical Staff Coordinators during the credentialing process to ensure timely and expeditious completion of process.



•         Oversees preparation and accuracy of credentialing reports.



•         Protects confidential information for peer review by the authorized personnel.



•         Secures appropriate peer competency references and prepares credentials files. Obtains primary source and other verifications in accordance with established guidelines. Communicates with applicants during credentialing process to ensure timely and expeditious completion of process. Researches incidents, malpractice claims, advisory letters/letters of concern etc. and request appropriate follow-up information from practitioner or other sources as indicated.



•         Initiates and participates in cross-training and cross-coverage of credentialing functions. Mentors and assists other Credentialing Specialists in all aspects of credentialing functions.



•         Maintains the credentialing database. Ensures data is accurately entered as evidenced by audit. Prepares reports in compliance with requests for information as demonstrated by documentation.



•         Facilitates standardization of the Credentialing package, Specialty specific Delineation of Privileges and Credentialing related letter templates, in order to promote Enterprise Credentialing Centralization and Standardization.



•         Coordinates and completes special projects in a timely manner. Appropriately prioritizes all tasks so that deadlines are met with continued focus on quality. Keeps staff apprised of any critical or major situations.



•         Drafts and assists in writing and reviewing policies and procedures and department rules and regulations. Ensures these do not conflict with medical staff by-laws and hospital policies and procedures/protocols.


Systems and Policy Management:



•         Design and support processes to ensure organization compliance with applicable regulatory standards.



•         Identify and recommend improvements in medical staff structure, by-laws and processes to facilitate accurate and timely credentialing and privileging.



•         In collaboration with the Medical Director, provides orientation to new medical staff officers and Medical Executive Committee members, regarding their duties and roles



•         Assure ongoing compliance with The Joint Commission standards.



•         Maintains current working knowledge of all regulations, statutes, laws, and standards that regulate medical staff governance and educates Medical Director, medical staff, and support staff on changes and updates, identifying the need for amendments to documents such as bylaws, rules or policies when required to maintain compliance.



•         Networks with others in the profession and healthcare industry to maintain industry standards, trends and issues affecting the medical staff organization.



•         Meets with members of the community to promote good public relations for the hospital.



•         Attends meetings of professional, civic and service organizations.



•         Performs other duties as assigned. 

Job Requirements

Minimum Qualifications:



  • Masters Degree in Art or Science with a specialization in Hospital Administration, Health Care Administration, Administrative Medicine or in Public Health when conferred for a program in hospital administration from an approved college or university; and,

  • Four years of administrative experience and background at responsible management and administrative levels; or,

  • An equivalent combination of training, educational background and experience in related fields and educational disciplines; and,

  • Knowledge of fundamentals of hospital organization, administration and standards, regulations and laws applicable to hospital operations. Knowledge of principles of business and personnel administration, management functions and support service functions and ability to direct and supervise personnel.


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Job Snapshot

Location US-NY-New York
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Health Care

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Snapshot
New York City Health and Hospitals Corporation
Company:
US-NY-New York
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description

Empower Every New Yorker — Without Exception — to Live the Healthiest Life Possible



Come join the largest public hospital system in the nation! Every day, we work together to make an extraordinary difference in the health and well-being of each individual we serve without exception. Join our team and help us create a positive patient experience.



NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.


 


Responsibilities:


Associate Director acts as liaison between Centralized Credentialing Office to Facility credentialing committees, physicians and medical staff department members to ensure that all aspects of credentialing/regulatory compliance issues with state and regulatory agencies are monitored;  that bylaw development and updates for all levels of healthcare services specially to cross credentialing of clinicians on all levels is adhere to; ensures that  medical staff credentialing is acted upon in a consistent and timely manner; and may oversee other Credentialing Specialists. 


Responsibilities include but are not limited to:



•          May be responsible to gather information and perform research in credentialing disputes under the direction of the Management.



•         Researches incidents, submission of applications for timely processing, and request appropriate follow-up information from facility Medical Staff Office or other sources as indicated.



•         Monitors and maintains the standards of The Joint Commission (TJC), the National Committee for Quality Assurance (NCQA), the Medical Staff Bylaws, Rules and Regulations and all other applicable regulatory requirements to ensure Centralize Credentialing compliance.



•         Coordinates the timely processing of all activities of initial and reappointment applications for completeness and in accordance with appropriate standards relative to the organizations Credentialing Manual. Provides credentialing support to the credentialing managers and supervisory support to the credentialing specialists. Maintains a sound working knowledge of credentialing and provides consultation to the Network regarding credentialing, to ensure all processes are in compliance with state statutes and regulatory agencies as demonstrated by observation.



•         Communicates with Medical Staff Coordinators during the credentialing process to ensure timely and expeditious completion of process.



•         Oversees preparation and accuracy of credentialing reports.



•         Protects confidential information for peer review by the authorized personnel.



•         Secures appropriate peer competency references and prepares credentials files. Obtains primary source and other verifications in accordance with established guidelines. Communicates with applicants during credentialing process to ensure timely and expeditious completion of process. Researches incidents, malpractice claims, advisory letters/letters of concern etc. and request appropriate follow-up information from practitioner or other sources as indicated.



•         Initiates and participates in cross-training and cross-coverage of credentialing functions. Mentors and assists other Credentialing Specialists in all aspects of credentialing functions.



•         Maintains the credentialing database. Ensures data is accurately entered as evidenced by audit. Prepares reports in compliance with requests for information as demonstrated by documentation.



•         Facilitates standardization of the Credentialing package, Specialty specific Delineation of Privileges and Credentialing related letter templates, in order to promote Enterprise Credentialing Centralization and Standardization.



•         Coordinates and completes special projects in a timely manner. Appropriately prioritizes all tasks so that deadlines are met with continued focus on quality. Keeps staff apprised of any critical or major situations.



•         Drafts and assists in writing and reviewing policies and procedures and department rules and regulations. Ensures these do not conflict with medical staff by-laws and hospital policies and procedures/protocols.


Systems and Policy Management:



•         Design and support processes to ensure organization compliance with applicable regulatory standards.



•         Identify and recommend improvements in medical staff structure, by-laws and processes to facilitate accurate and timely credentialing and privileging.



•         In collaboration with the Medical Director, provides orientation to new medical staff officers and Medical Executive Committee members, regarding their duties and roles



•         Assure ongoing compliance with The Joint Commission standards.



•         Maintains current working knowledge of all regulations, statutes, laws, and standards that regulate medical staff governance and educates Medical Director, medical staff, and support staff on changes and updates, identifying the need for amendments to documents such as bylaws, rules or policies when required to maintain compliance.



•         Networks with others in the profession and healthcare industry to maintain industry standards, trends and issues affecting the medical staff organization.



•         Meets with members of the community to promote good public relations for the hospital.



•         Attends meetings of professional, civic and service organizations.



•         Performs other duties as assigned. 

Job Requirements

Minimum Qualifications:



  • Masters Degree in Art or Science with a specialization in Hospital Administration, Health Care Administration, Administrative Medicine or in Public Health when conferred for a program in hospital administration from an approved college or university; and,

  • Four years of administrative experience and background at responsible management and administrative levels; or,

  • An equivalent combination of training, educational background and experience in related fields and educational disciplines; and,

  • Knowledge of fundamentals of hospital organization, administration and standards, regulations and laws applicable to hospital operations. Knowledge of principles of business and personnel administration, management functions and support service functions and ability to direct and supervise personnel.


Associate Director, Credentialing, Healthcare Improvement Apply now