Job Description

We’re making Maryland stronger!

With roots that go as far back as 1895, the UM Rehab & Ortho Institute continues to be a pioneer in orthopedics and neurological disorders. From bones to brains, our cutting-edge hospital heals even the most serious of injuries, specializing in everything from total joint replacement to spinal cord injuries and neurological condition. In total, our 141-bed facility welcomes over 3,000 patients every year. As the state’s largest provider of inpatient rehabilitation services, we offer some of the most advanced therapies for stroke, spinal cord injury, traumatic brain injury, orthopedic and sports injury, among many others.

Job Description

Job Summary

The Manager performs the administrative functions related to medical and resident credentialing. Oversee and supports Medical Staff committees. Under general direction, manages the credentialing process to ensure compliance with hospital policies, regulatory bodies, and TJC. 

Primary Responsibilities

Credentialing and Privileging

•  Oversee all aspects of initial and reappointment credentialing for Medical Staff, AHPs, and residents / fellows. 
•  Ensure that data necessary for credentialing and privileging is requested and collected in a timely manner from applicants and other parties.
• Ensures that primary source verification of licensure, training, board certification, DEA, malpractice coverage, prior employment, and the National Provider Data Bank (NPDB) is performed.
• Ensures timely file completion and coordinates approval workflows, ensuring presentation to the Credentials Committee, Medical Executive Committee (MEC), and Governing Body.
• Maintains privilege delineations consistent with Medical Staff Bylaws and regulatory standards.
•  Maintains accurate files for all credentialed and privileged Medical Staff and AHPs.
• Maintains the electronic credentialing database.
• Works in conjunction with University of Maryland Medical System (UMMS) leadership and colleagues from other UMMS member organizations Medical Staff Offices to continuously improve all aspects of the Medical Staff Office, including the use of new technologies and processes to improve operational efficiency and reduce redundancy. 

Regulatory Compliance

Ensures full compliance with Medical Staff Bylaws, TJC, CMS, NCQA, and state licensure requirements, including: 

• Credentialing and privileging audits 
• FPPE and OPPE completion, in conjunction with the Quality Department 

Medical Staff Governance and Administration 

Provides administrative support to the Medical Staff President, Officers, Credentials Committee, MEC, and other assigned committees: 

• Prepare agendas, minutes, and follow-up actions 
• Track committee approvals and corrective actions
• Collaborate with clinical leaders (Division Chiefs) and hospital administration to support effective medical staff governance and provider onboarding.
• Coordinate new provider onboarding and orientation, in collaboration with HR and clinical departments.

Leadership and Operational Management

• Supervise and mentor Medical Staff Office personnel, ensuring efficient, high-quality workflows and excellent customer service.
• Maintain courteous and effective relationships with co-workers and other members of the Hospital staff.
• Develop and report performance metrics relate to credentialing timelines, provider onboarding, and regulatory readiness.
• Establish and maintain professional, confidential, and collaborative relationships with providers, hospital departments, and external agencies.

Qualifications

Education & Experience - Required

• Associates degree or higher from an accredited college in health care administration, business, or related field.
• Minimum of 5 years of credentialing/ Medical Staff experience, with at least two years in a hospital or health system setting.
• Must have a strong hospital-based credentialing background

Education & Experience - Preferred

• Bachelor’s degree or higher
•  Supervisory experience
• Certified Professional Medical Services Management (CPMSM) and/ or Certified Provider Credentialing Specialist (CPCS) Certifications.

Knowledge, Skills, & Abilities

• Expert knowledge of Medical Staff credentialing, privileging, and governance processes.
• Thorough understanding of TJC, CMS, NCQA, and state regulatory requirements. 
• Proficient in credentialing software systems; experience with MD Staff preferred.
• Strong interpersonal, written, and verbal communication skills
• Work collaboratively with medical staff and administrative leadership.
• Ability to manage confidential and sensitive information in compliance with hospital policy and HIPAA. 

Additional Information

All your information will be kept confidential according to EEO guidelines.

Compensation:

• Pay Range: $40.60 - $60.93
• Other Compensation (if applicable): n/a

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Job Tags

Full time, Work at office,

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