Headquartered in Rapid City, S.D., Monument Health is a community-based health care system with a mission to “Make a Difference, Every Day.” The system offers care in 31 medical specialties and serves 14 communities across western South Dakota and in eastern Wyoming. With over 5,000 physicians and caregivers, Monument Health is composed of 5 hospitals and 40 medical clinics and specialty centers. Monument Health joined the Mayo Clinic Care Network in January 2020.
At Monument Health, we will focus on delivering quality care while showing compassion to our patients, to each other and to our communities. We are taking the next steps in providing a stronger future and healthier communities for generations to come.
Monument Health offers a competitive salary based on experience, full benefits package, and potential sign on and relocation package.
Rapid City Hospital is located in an outdoor paradise surrounded by mountains, lakes and national forests. Access to outdoor activities such as hiking, kayaking, skiing, snowboarding, mountain biking, boating, water skiing, fishing and so much more makes this area an ideal place to live and work! Rapid City, South Dakota has a small-town atmosphere with access to amenities such as a regional airport and a variety of shopping and dining choices year around!
The Medical Staff Services Director works closely with VPMA, Chief of staff, other Medical Staff leaders, the Safety and Risk Management Department, Physician Recruitment and Patient Financial Service to deliver high quality of care. This role is critical in advancing our mission to “Make a difference, Every Day” and to provide support to the physician leaders. The Director providers support to a team of 14 and medical staff service department operations as it related to provider credentialing, privileging, medical staff functions, Provider and Facility Enrollment, bylaws, and medical staff governance processes.
Job Description of Essential Functions
The Director Medical Staff Services is the administrative liaison between the medical staff (5 independent hospital locations for Monument Health System) and hospital administration as mandated by the hospital’s Board of Directors.
Leadership accountability will be expected in managing practitioner competency systems, recognizing opportunities for improvement, monitoring performance of personnel in MSS as well as the various Medical Staff Departments and Committees, policies, procedures and legal governance documents, support of medical staff leadership, medical staff services operations, medical staff and hospital collaboration and demonstrates leadership by supporting and promotion current practices and by using and integrating current and future technologies.
Credentialing, Privileging, Peer Review and Enrollment
Responsible for developing processes that support the medical/professional staff and their responsibilities as it relates to Joint Commission, CMS and NCQA accreditation compliance, Network and Rapid City Bylaws and the hospital’s mission and strategic plan. Components of this include but is not limited to:
Directing and providing oversight to the credentialing, privileging, expirables, and appointment process.
On a monthly basis tracks progress of appointments, reappointments, changes in status and enrollment.
Comprehensive knowledge of procedures and techniques that impact privilege and proctorship plans.
Leading Medical Staff Coordinators in maintaining, creating and updating privilege forms to fit all specialties.
Maintains, creates, and modifies existing department policies to maintain accreditation standards for NCQA.
Coordinates, maintains and reviews 2 sets of Bylaws and Governing Documents to ensure that all accreditation standards and Conditions of Participation are continuously met.
Ongoing reporting on enrollment denials, claims on hold and patterns in delayed payment to the Chief Financial Officer, Patient Financial Services Leadership and the Managed Care Team.
Coordinates and reviews all changes and reporting in Echo Credentialing Software.
Direct oversight and planning of credentialing quality improvement projects as it relates to the departments specialists and coordinators.
Medical Staff Leadership Support
Provides administrative support to VPMA, Chief of Staff, Department and Committee chairs and other Medical Staff Leaders.
Carries out tasks assigned by the MECs and or Presidents of the Medical Staff
Manges process related to investigative, disciplinary and legal proceedings, such as fair hearing and appeals.
In collaboration with the VPMA, serves as liaison between the Medical Staff and Hospital.
Timely response to medical staff issues, facilitation of teamwork, and communication and issue resolution with other hospital departments.
Create and implement process workflows to create improvements and efficiencies.
Recruit, select, assist with training, and manage Medical Staff Services staff.
Provide regular performance evaluations and educational opportunities for members of the department to promote professional growth and preparation for certification.
Coordinates all projects related to provider & facility enrollment, credentialing and accreditation standards (ie. Location changes, new services lines, delegation of credentialing, accreditation support for new and existing programs.)
Remains agile and flexible while anticipating future trends/opportunities.
Fosters an environment of innovation, creation and implementation of new services and sustainability.
Performance will be evaluated in the areas of regulatory knowledge and compliance, provider enrollment coordination, collaboration with recruitment and department directors, strategic development, continuation of peer review and credentialing/privileging for 1100 providers and optimizing resources to ensure compliance with regulatory requirements regarding credentialing, privileging and peer review.
Make a difference. Every day.
Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.
Required: Education - Bachelors degree in Business Administration Management or related field
Preferred: Experience - 3+ years of Supervisor Experience; 5+ years of Medical Staff Experience Education - Masters degree in Healthcare Certifications - Certified Professional Medical Services Management (CPMSM) - Accredited University or accredited training professionals; National Association of Medical Staff Services (NAMSS) Certification - Accredited University or accredited training professionals
Physical Requirements: Light work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.
Internal Number: 21_4140
About Monument Health
Headquartered in Rapid City, S.D., Monument Health is a community-based health care system with a mission to make a difference, every day. The system offers care in 31 medical specialties and serves 14 communities across western South Dakota and in eastern Wyoming. With over 5,000 physicians and caregivers, Monument Health is composed of 5 hospitals and 40 medical clinics and specialty centers. Monument Health is a member of the Mayo Clinic Care Network.
Monument Health is committed to the future of medicine, with medical training partnerships, a medical residency program and more than 130 active research studies. We are confident about western South Dakota’s future, and we’re honored to be your partner in delivering excellence in health care.