Dynamic Medical Staff Affairs Manager with extensive experience at the Children's Hospital of Philadelphia, excelling in credentialing processes and regulatory compliance. Proven track record in quality improvement and team supervision, driving operational efficiencies and enhancing performance management. Adept at database management, ensuring accuracy and compliance in all medical staff applications.
Overview
2
2
years of professional experience
Work History
Provider Enrollment Services Supervisor
AmeriHealth Caritas
Philadelphia, PA
04.2024 - Current
Collaborated with management on resource planning and utilization for provider data management.
Forecasted production to ensure timely adjudication of work requests.
Implemented quality enhancement strategies in alignment with established policies and procedures.
Maintain current knowledge of all state requirements and all NCQA requirements.
Participate in the migration to the new platform.
Drive improvement in provider/member satisfaction through operational efficiencies.
Adhere to the organization’s code of confidentiality.
Established and accomplished team goals through independent work and strategic planning.
Medical Staff Affairs Manager
Childrens’ Hospital of Philadelphia
Philadelphia, PA
04.2023 - 04.2024
Supervise and Manage Medical Staff Affairs Coordinators
Engage with Division Administrators regularly to assess status of medical staff applications, communicate new standards, and evaluate privileging criteria.
Communicate regularly with the Director of the Medical Staff Office, the Chair of the Credentials Committee, the NPHP Committee, and the APNPA Committee..
Oversee biennial reappointment process in collaboration with MSA coordinators and Division representatives for compliance with CHOP Medical Staff Bylaws and regulatory agency standards.
Collaborate with Director and MSA coordinators to accelerate clean application processing
Supports the Director with the annual planning of the operating and capital budget needs.
Maintain Joint Commission accreditation, and DOH compliance.
Facilitate the implementation of new credentialing and privileging software applications.
Manage periodic inquiries for medical staff information across hospital departments such as Public Relations, Development, Legal, and Marketing.
Update Director about licensure or accreditation topics, provider complications, projected changes, and issues related to deadline deliveries immediately
Develop appropriate quality control processes to monitor MSA coordinators’ effectiveness and productivity.
Assist the auditor in preparing for and participating in regulatory agency site visits and surveys.
Independent Contractor – Member Services at AmeriHealth Caritas Pennsylvania - Medicaid & Keystone First – AmeriHealth Caritas Pennsylvania Community Health Choices – Keystone First Community Health ChoicesIndependent Contractor – Member Services at AmeriHealth Caritas Pennsylvania - Medicaid & Keystone First – AmeriHealth Caritas Pennsylvania Community Health Choices – Keystone First Community Health Choices