Manager of Credentialing - Medical Staff Services - Full Time

Orlando Health, Inc.; Melbourne (FL); On-site; USD 70,000 - 110,000; Full time

Job summary

Orlando Health Melbourne Hospital is seeking a Medical Staff Credentialing Manager to oversee initial credentialing and reappointment activities in line with regulatory standards and hospital bylaws. The role leads the credentialing team, manages workflows, and ensures accurate, timely processes across clinical staff.

Success requires attention to detail, collaboration with legal and medical leadership, and ongoing staff development to uphold high standards of quality and safety.

Qualifications

• Bachelor's degree in Healthcare Administration or related field.
• 5+ years of Medical Staff credentialing experience or 8+ years substituting for degree.
• CPMSM/CPCS certification within 2 years of hire.

Responsibilities

• Oversee credentialing and privileging processes for physicians and allied health professionals.
• Drive adherence to regulatory, accreditation, and organizational by-laws and policies.
• Lead and develop the credentialing team; hire, coach, and evaluate staff.
• Coordinate with legal, medical leadership and departments to update governance documents.
• Manage budgeting and reporting for the Medical Staff Services office.
• Educate staff on objectives and ensure timely, compliant credentialing activities.
• Maintain relationships with regional/national associations to advance credentialing practices.

Skills

Attention to detail

Customer service

Leadership

Workflow systems

Education

Bachelor's degree in Healthcare Administration

CPMSM or CPCS certification

Tools

Workflow software

Job description

Position Summary

“Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.

About Orlando Health Melbourne Hospital

Orlando Health Melbourne Hospital is a comprehensive medical and surgical acute care facility serving the Brevard County Space Coast as a trusted healthcare provider since 2002. Conveniently located in Melbourne, the 119-bed hospital has all private rooms and is uniquely designed for your comfort and a positive patient experience. Our dedicated team of physicians, nurses, clinicians and medical professionals is committed to delivering the highest level of quality and compassionate care.

We provide a complete scope of care, with advanced technology and expertise in a number of specialties, including cardiovascular care, digestive health, emergency care, orthopedics and surgical services. Recognized for high standards, we have earned full hospital and laboratory accreditation from The Joint Commission, and we are the first hospital in Brevard County to receive spine surgery certification for our specialized spine program. The Joint Commission’s Gold Seal of Approval® distinguishes healthcare organizations and programs that exemplify their commitment to using best practices to improve safety and quality for their patients, staff and community. As part of our commitment to quality care, we also are a participant in the American College of Cardiology CathPCI Registry® for improved diagnostic cardiac catheterizations and percutaneous coronary interventions for heart patients.

WHY ORLANDO HEALTH?

Competitive Pay

Evening, nights, and weekend shift differentials offered for qualifying positions.

All Inclusive Benefits (Starting on Day One)

• Student loan repayment
• tuition reimbursement
• FREE college education programs
• retirement savings
• paid paternity leave
• fertility benefits
• back up elder and childcare
• pet insurance
• PTO/Holidays
• more for full time and part time employees

Employee-centric

Orlando Health has been selected as one of the “Top Places to Work in Healthcare” by Becker’sHealthcare.

Company is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.

A Brief Overview

The Medical Staff Services Credentialing Manager is responsible for overseeing the development, implementation, and integrity of the initial credentialing and reappointment activities in accordance with regulatory and accreditation standards, as well as the Orlando Health Bylaws, Policies and Procedures, Rules & Regulations. This position also manages team member functions and accountability.

Our people are passionate about what they do, the product they sell, and the customers they serve. If you're looking for an opportunity to be a part of a work family that values collaboration, innovation and dedication, we're the right company for you.

Section 1557 Non-Discrimination

The Office for Civil Rights (OCR) enforces Section 1557 of the Affordable Care Act (Section 1557), which prohibits discrimination on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, gender identity, and sex characteristics), in covered health programs or activities. 42 U.S.C. 18116.

Responsibilities

• The Manager, Credentialing, Medical Staff Services effectively implements administrative and operational activities of the Medical Staff and its Leadership. Operationalizes results of discussions, recommendations, and actions of the Medical Executive Committee and the Credentials Committee.
• Exhibits extensive attention to detail and requires attention to detail from all team members.
• Exhibits and promotes within the Medical Staff Services team excellent customer service to Medical Staff leaders, medical staff members, medical staff applicants, hospital administration, and internal and external customers.
• Implements all credentialing and privileging processes and procedures for all physicians and allied health practitioners, including establishing qualifying criteria for initial appointment.
• Formulation and revision of all application materials; professional profiling for reappointment.
• Assists direct leader, in concert with legal counsel and Medical Staff Leadership, to facilitate amendments to Medical Staff governance documents to ensure compliance with regulatory, statutory, legal, and accreditation bodies and their required standards, as well as with Medical Staff Bylaws, Policies/Procedures, and Rules & Regulations for all facilities.
• Assists direct leader with physician investigations (both behavioral and clinical competency), notifies practitioner of adverse action, and administers the Fair Hearing & Appeal Process, as required.
• Primary responsibility for orientation and training, system upgrades/updates, and systems reporting to all downstream systems from the credentialing database workflow system.
• Creates implements and reconciles clinical privileges to numerous internal clinical service areas.
• Responsible for planning, organizing, leading and directing Medical Staff Services credentialing team activities; appropriately addresses staffing needs, hires, trains, evaluates, coaches and manages team, including establishing goals and objectives for the development of departmental human resources.
• Assists direct leader with preparing, tracking, and manages fiscal budget and restricted account.
• The Credentialing Manager will ensure that the credentialing database workflow system use is maximized.
• The Credentialing Manager of the Medical Staff Office is a supportive, effective, efficient team member dedicated to meeting the needs of the Medical Staff and its Leadership.
• Educates team members on organizational objectives and ensures their understanding of the team's part in meeting those objectives.
• Manages various personnel functions including hiring, work assignments, coaching plans, and disciplinary actions for the medical staff office personnel.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.
• Operates with independent judgment on behalf of the Chief of Staff and the Credentials Committee Chairman * Coordinates and works effectively with the Health Information Management, Regulatory, Infection Control, Quality Teams, and all other departments that impact the Medical Staff at the organization * Participates in regional and National Associations for the advancement of the medical staff organization, credentialing and privileging, and medical staff services professionals. Representatives Orlando Health through community interaction and related organizations. * Continually updates skills, knowledge and certification. Conducts literature reviews and research on changes in medical staff privileging and makes proposals to enhance credentialing and privileging activities within the organization. * Actively participates in professional organizations, including FAMSS, etc. for networking purposes

Qualifications

• Bachelor's degree in Healthcare Administration and Management, or a related field OR
• 8 years of experience in Medical Staff Services credentialing and operations may be substituted for bachelor’s degree.
• Five (5) years of experience interacting with hospital administration, Medical Staff Leadership, Medical Staff physicians, credentialing activities and/or two years directly related medical staff support experience. Significant experience in use of workflow systems and development of reporting. Experience with change management and streamlining of workflow processes.
• CPCS or CPMSM certification required within 2 years of hire.