Credentials Manager, Medical Staff

If you are an existing employee of South Shore Health then please apply through the internal career site.

Requisition Number: R-21028

Facility: LOC
0001 - 55 Fogg Road, 55 Fogg Road Weymouth, MA 02190

Department Name: SSH Medical Staff

Status: Full time

Budgeted

Hours:

40

Shift: Day (United States of America)

The Medical Staff Credentials Manager is a key leadership role responsible for overseeing the credentialing and re-credentialing process for all providers at South Shore Health. The Credentials Manager oversees the credentialing and re-credentialing processes for healthcare providers, ensuring compliance with federal and state regulatory requirements, medical staff bylaws and organizational policies. Reporting to the Director of Medical Staff Affairs, this role manages the verification of provider qualifications, coordinates with insurance networks, and maintains accurate credentialing databases.

This is an excellent career development opportunity! The Credentials Manager oversees the timely credentialing, re-credentialing, and clinical privileges of all South Shore Health providers. They are responsible for ensuring the integrity, accuracy, and completeness of provider records and database entries. This includes collaborating with physician leadership to develop and revise privilege forms as needed. In this role, the incumbent provides guidance and direction to the Medical Staff coordinators, and occasionally other staff, on special projects.

They are responsible for the training, mentoring, professional development, and evaluation of the credentialing team. The Manager also frequently assesses departmental productivity and develops business strategies to ensure effective operations. Ensuring compliance with The Joint Commission (TJC), National Committee for Quality Assurance (NCQA), and the organization’s Medical Staff Bylaws, Rules and Regulations is a key aspect of this position. Coordinates the Credentials Committee and other assigned medical staff committees, managing agendas, minutes, reports, and follow-up.

This role requires a strong understanding of the FPPE and OPPE processes, as the Manager oversees and manages these critical provider evaluation activities. The Credentials Manager must exemplify a culture of excellence and customer service, serving as a positive representative of South Shore Health both internally and externally.

Compensation Pay Range: $ - $

• Collaborates with the Director of Medical Staff Services/Affairs, Medical Staff Leadership, and Hospital Leadership to organize and maintain systems that coordinate the credentialing and re-credentialing process for all South Shore Health credentialed providers.
• Manages the timely credentialing, re-credentialing, and clinical privileges of SSH providers.
• Oversees the integrity, accuracy, and completeness of applications for new and reappointed staff, collaborating when necessary, with the director and chair of credentials, following established process for problem applications.
• Collaborates with the MSSD staff and Hospital Leadership in assisting providers with the application process for timely appointment, reappointment, clinical privileges, and expirable in accordance with Medical Staff Bylaws, Rules and Regulations, hospital policies and procedures and in accordance with The Joint Commission (TJC), CMS and other state and federal regulatory agencies as required.

• Oversees the integrity, accuracy, and completeness of database entries.
• Oversees and manages the maintenance of electronic provider records as required.

• Collaborates with physician leadership in the development, or revision of, current privilege forms as assigned.

• Prioritizes work and provides guidance and direction to Medical Staff coordinators and on occasion of other staff assigned to assist with special projects.
• Responsible for, in collaboration with the director, the training, mentoring, ongoing professional development, and evaluations of all credentialing team members.
• Conducts regular MSSD staff educational sessions.

• Frequently…