Senior Director, Medical Staff Services

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

40

Department:

910400 URMFG Administration

Work Shift:

UR - Day (United States of America)

Range:

UR URG 118

Compensation Range:

$140,350.00 - $210,525.00

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

Provides executive oversight of the health care practitioner credentialing, clinical privileging, and payer enrollment processes for the UR Medicine Health Care System and other outside health care contracted organizations. Provides executive oversight of the enterprise software platform utilized throughout the UR Medicine Health Care System to carry out these functions.

Responsible for establishing the operational plan for credentialing, privileging and payor enrollment including the establishment of common practices/processes across the system that meet stakeholder expectations, achieve financial objectives, and reduce liability and risk. Works in close partnership with the University of Rochester Medical Center (URMC) Information Systems Division, URMC Office of Integrity and Compliance, URMC Office of Quality Assurance, URMC Office of Counsel, University of Rochester Medical Faculty Group, SMD Office of Academic Affairs, and Affiliate Hospitals to enhance efficiency, accuracy, compliance, data-driven decision-making and to drive operational excellence and advance the quality of health care practitioners and patient safety of the organization and community.

Comprehensive Clinical Privileging & Data Management Systems:

• Provides executive oversight of the robust practitioner credentialing and data management system that ensures the accuracy and completeness of practitioner information that supports the organization’s data needs in alignment with IT services.
• Provides executive oversight of the specialty specific, criteria based electronic clinical privileging system (specialty specific procedure descriptions linked to CPT codes) implemented at all UR Medicine Health Care Facilities, assuring compliance with regulatory requirements, accreditation standards and organizational policies.
• Coordinates and collaborates with physicians, dentists and allied health practitioner leaders throughout the UR Medicine system to assure compliance with the criteria based clinical privileging description regulatory requirements.
• Responsible for the development and maintenance of the MSS Department Website which serves as a tool for leaders, staff and practitioners throughout the system to access information related to practitioner credentialing and payer enrollment and to obtain applications, reports and required documents and forms.
• Oversee the collaboration of the MSS IT team with the University IT and Security teams, Web Services and the eRecord team to ensure the secure and efficient operation of the credentialing technology.

Centralized Credentialing Verification Functions:

• Directs the practitioner (physician and allied health practitioners - employed & non-employed) credentialing and re-credentialing application process for medical staff membership and clinical privileges for the UR Medicine Health System affiliated hospitals, nursing homes, surgical centers and health centers as well as for other non-affiliated regional contracted health care organizations.  This includes credentials verification and background investigation of education, training, malpractice claims history, clinical experience and competence, specialty certifications and other data collection as required by the Joint Commission, CMS, NYS, NCQA, and the applicable entities’/hospitals’ bylaws and credentialing policies.  Ensures that files are complete and securely submitted to the respective entities upon completion and in accordance with the requirements of their contracts.

Practitioner Credentialing & Privileging R