- Where
- Marietta, Georgia, United States of America
- Level
- Senior
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.
Work Shift
Day (United States of America)
Job Summary :
The Director, Credentials Verifications Organization (CVO) provides strategic leadership to the system CVO and has overall responsibility for leading and maintaining a high quality and comprehensive credentialing and privileging program supporting Wellstar's mission, vision and values. Through effective staffing and management and collaboration with applicants and other departments, this position oversees the successful implementation of the system application process to credential and privilege all practitioners in accordance with the bylaws, rules and regulations and policies of Wellstar Health System. In addition, manages the expectations and outcomes around processing times as well as communication with applicants, vendors and other Wellstar departments This position has responsibility for monitoring all applicable regulatory laws and statutes (State and Federal) and accreditation standards. This includes, but not limited to, system compliance with State, CMS, and Joint Commission requirements
Core Responsibilities and Essential Functions :
Credentials Functions: Provide high-quality, single-application process for Medical Staff and Allied Health Professionals in a timely, cost-effective manner.
• a. Oversight of credentialing/privileging for Medical Staff, Advanced Practice Professionals and Allied Health Professionals for Wellstar Health System hospitals, Wellstar Medical Group, PHO, Wellstar Clinical Partners and delegated credentialing for managed care organizations.
• b. Assure application process initiated and completed per Medical Staff Bylaws, the Joint Commission and NCQA standards, CMS and state/federal regulations.
• c. Analytical responsibility for credentialing information obtained during application process.
• d. Responsible for maintenance of current, electronic credential file including maintaining current required documents (professional license, DEA, liability insurance, board certification, etc.).
• e. Oversight of communication with all applicants regarding membership and privileging.
• f. Assures appropriate interface with Wellstar Legal and Risk Management regarding credentialing
Regulatory Compliance/Continuous Survey Readiness:
Maintains current working knowledge of all regulations, statutes, laws and accreditation standards that regulate the organized medical staff and the credentialing process. Provide guidance and serve as expert resource to the Medical Staff Leadership and organization in these areas. Identify the need for amendments to documents such as Medical Staff Bylaws, Policies or Rules and Regulations when required to maintain compliance.
•a. Responsible for compliance with all appropriate regulatory body standards, state requirements and procedures.
• b. Demonstrates accurate knowledge of Medical Staff Bylaws, Rules and Regulations, and policies and procedures.
• c. Coordinates and participates in development and revision of documents to ensure compliance.
• d. Acts as liaison between Medical Staff and Health System attorneys on medico-legal issues as needed.
Communication:
Serve as liaison between Medical Staff, Administration, Senior Leadership and other Departments. Assures customer service by the Credentials Verification Organization. Improve and promote communication and teamwork among the various Medical Staff Organizations as well as within the Department and between Medical Staff Services and Medical Staff Leadership, Administration, Senior Leadership and…