Description
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The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and families throughout Michigan and beyond. A premier healthcare resource, our mission is to help people live happier, healthier lives. The hospitals of the Detroit Medical Center are the Children's Hospital of Michigan, Detroit Receiving Hospital, Harper University Hospital, Hutzel Women's Hospital, the DMC Heart Hospital, Huron Valley-Sinai Hospital, the Rehabilitation Institute of Michigan and Sinai-Grace Hospital.
DMC's 150-year legacy of medical excellence and service provides patients and families world-class care in cardiovascular health, women's services, neurosciences, stroke treatment, orthopedics, pediatrics, rehabilitation, organ transplant and other general and specialty services.
DMC is a key partner in Detroit's resurgence, which continues to draw national and international attention. A dedicated corporate citizen with strong community ties, DMC is one of the largest and most diverse employers in Southeast Michigan.
Summary Description Under limited supervision, coordinates and oversees the professional practice evaluation process for Medical Staff and Allied Health Professionals.
Fully responsible for accurate preparation of professional practice evaluations submitted to the Chiefs and Specialists-in-Chief for review. Maintains routine reporting tools for use in monitoring the progress of reviews and assures expeditious follow through on action items.
Works collaboratively and maintains regular communication with individual hospital medical affairs coordinators, medical staff leadership and others to ensure efficient processing of work; obtains and relays information and resolves problems.
Deals sensitively and professionally with practitioners regarding problems and queries. Provides assistance and training to reviewers.
Maintains working knowledge of DMC Medical Staff Bylaws, Rules and Regulations, policies and procedures; and The Joint Commission, NCQA and CMS standards. Interprets these to Medical Staff and clinical departments.
Actively assists with assessment of compliance, development and coordination of key Medical Staff policies as they relate to professional practice evaluations. Identifies procedural problems related to the process and recommends changes to provide resolution.
Works collaboratively with the credentialing database administrator to develop and maintain interactive, electronic tracking and monitoring tools. Works with the RN Nurse Reviewer to produce accurate and timely FPPE and OPPE reports.
Works with Quality Department team members to ensure facilitation of any referrals to the medical staff related to complaints, grievances or safety events. Prepares the monthly FPPE/OPPE committee reports.
Ensures confidentiality of patient and physician information, PHI, and demonstrates understanding of HIPAA. Takes initiative in keeping Director fully informed on work-related issues.
Willingly takes on additional assignments as needed within the department, including providing back up for other staff as necessary.
Qualifications
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Minimum Qualifications 1. Bachelor’s degree in Business Administration, Liberal Arts or related field required.
2. Two to three years of credentialing/medical staff services experience preferred.
3. Experience with computerized database systems. ECHO credentialing software experience preferred.
4. Proficient in Microsoft Word, Excel, and PowerPoint.
5. Knowledge of The Joint Commission, NCQA and CMS medical staff standards.
6. Basic knowledge of medical terminology.
7. Medical Staff Services or Credentialing Certification (CPMSM or CPCS) preferred.
