Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.
The Provider Credentialing and Enrollment Director provides leadership, management and operational oversight of the medical staff and provider enrollment. The Director assures that the Medical Staff meets all of its responsibilities as delineated in the hospital medical staff Bylaws and Rules & Regulations, as well as other requirements as per state and federal legislation. Assures timely and valid primary source verification for all credentialed providers, including physicians and advanced practice providers, on the medical staff through the ACHS and managed care delegated credentialing agreements. Ensures allied health professionals are credentialed according to Joint Commission standards, including, but not limited to LCSWs, nutritionists, midwives, etc. Assures enrollment of providers with federal and state payers.
The Director actively collaborates with and provides functional expertise/knowledge to the Chief of Staff, Medical Executive Committee (MEC) and additional medical staff leaders on matters pertaining to functions of the MSO, including but not limited to governance, privileging, and credentialing including delegated credentialing, provider enrollment, performance monitoring and compliance with regulatory standards. The Director manages/supervises the Medical Staff Office (MSO) staff including recruiting, hiring, orienting, training, promoting, disciplining, and terminating the staff when necessary. The Director is responsible for monitoring productivity of credentialing and privileging processes, launching/sponsoring improvement initiatives, collaborating with JHHS as appropriate, sustaining results and maintaining compliance with external regulatory agencies.
Ideal candidates will have a Bachelor of Science in Business,Healthcare Administration or relatd field required, Masters preferred plus 10 years work experience as director or manager of medical staff administration in an acute care or academic hospital setting. Current Certified Professional Medical Staff Management (CPMSM) and/or Certified Provider Credentialing Specialist (CPCS) with the National Association Medical Staff Services is required. Expert understanding of and the ability to interpret accreditation/regulatory requirements related to medical staff. Proven ability in fiscal and human resource management. Excellent decision-making and problem solving skills. Excellent analytical, interpersonal, organizational, written and verbal skills. Ability to maintain effective working relationships with various constituencies. Ability to prioritize tasks and manage a diversity of assignments simultaneously.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.