Medical Staff Services Manager (4777)

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Under the direction of Director, Managed Care & Credentialing, this position is responsible for the management of provider onboarding, licensing, credentialing and enrollment for SIU Healthcare and SIU School of Medicine(FQHCs). The incumbent is responsible for the daily supervision of the staff assigned to the Credentialing Team. The incumbent is responsible for stream lining existing processes, creating efficiencies and maintaining a computerized credentialing system to ensure compliance with federal and state regulations regarding licensure and certification of medical providers to over all ensure timely and accurate credentialing, privileging and health plan enrollments for SIU providers. The incumbent will be responsible for assuring that SIU Medicine credentialing and recredentialing files comply with National Committee for Quality Assurance (NCQA) standards and requirements. The incumbent serves as a liaison between SIUHealthcare and SIU School of Medicine (FQHCs},providers, individual departments and outside organizations in managing the credentialing, licensing and enrollment for provider privileges in a timely, well-communicated manner that can be easily tracked with in a data system. The Incumbent acts as a resource to SIUHealthcare and SIU School of Medicine (FQHCs) In planning for new clinics and expansion of services and service area. This position works with administration in the oversight and management of SIU Healthcare and SIU School of Medicine (FQHCs} credentialing team.

*This position is ON SITE only*

Credentials to be Verified by Placement Officer

1. High school diploma or equivalent.
2. Any one or combination totaling two (2) years (24 months) from the categories below:
   1. College course work in health care administration, health information technology, health sciences, public health, social sciences, business administration, or a closely related field, as measured by the following conversion table or its proportional equivalent:
      • 30 semester hours equals one (1) year (12 months)
      • Associate’s Degree (60 semester hours) equals eighteen months (18 months)
      • 90 semester hours equals two (2) years (24 months)
      • Bachelor’s Degree (120 semester hours) equals three (3) years (36 months)
   2. Work experience in a medical setting which could include business administration (office administration, billing, collections), customer service, health information technology, medical insurance, patient admission/registration, patient services, or closely related experience.
3. Two years (24 months) months of work experience comparable to that of the Medical Staff Services Specialist II of the series.

Knowledge, Skills & Abilities (KSA’s)

1. Ability to communicate properly and effectively in verbal and written form with various levels of Hospital, College, and Medical Staff.
2. Ability to work independently, set work priorities, and determine short- or long-term goals, and strategies to achieve them.
3. Ability to utilize Medical Staff credentialing software and other information technology-related work products.
4. Ability to apply the content of Medical Staff Organizational Documents.
5. Apply knowledge, expertise, sound judgment, and other references and resources as necessary to generate and evaluate solutions and recommendations.
6. Ability to apply state and regulatory standards for Medical Staff.
7. Maintain confidentiality regarding legal matters, privacy issues, information technology, and data integrity.
8. Understand clinical competence evaluation concepts, key functions, terminology, and work products, including evaluation tools and techniques used.
9. Ability to adapt behavior and lead, champion, and help others in response to new information or changing circumstances.
10. Understand and apply performance improvement concepts.
11. Understand budget/finance concepts.
12. Understand managed care concepts, key functions, processes, terminology, and work products.

Condition of Employment

Out of State Applicants that apply to Springfield vacancies in classifications in the occupational area of Professional, Semi-Professional, or Managerial will be subject to the following Condition of Employment: Pursuant to the State University Civil Service System, an out-of-state resident who is hired into this position must establish Illinois residency within 180 calendar days of their start date.

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If you require assistance, please contact the Office of Human Resources at hrrecruitment@siumed.edu or call 217-545-0223 Monday through Friday, 8:00am-4:30pm.

The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.
The SIU School of Medicine Annual Security Report is available online at https://www.siumed.edu/police-security. This report contains policy statements and crime statistics for Southern Illinois University School of Medicine in Springfield, IL. This report is published in compliance with Federal Law titled the
“Jeanne Clery Disclosure of Campus Security Policy and Crime Statistics Act.”

Southern Illinois University School of Medicine is an Affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law.

Pre-employment background screenings required.