| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Street Address Sunhollow CourtHaslett, MI Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEPage 1 of 2Medical Staff Services Professional with 9 years of experience including Management experience in credentialing, provider enrollment and regulatory compliance for acute care hospitals and specialty hospitals. Most recently as Manager of Credentialing & Provider Enrollment encompassing multiple states in the Midwest Region specializing in Ophthalmology. MEDICAL SERVICES PROFESSIONAL SKILLS SUMMARY Meeting Management Payer Enrollment Initials & Reappointments Expirables Bylaws Privilege Forms Auditing FPPE/OPPE trainedPROFESSIONAL EXPERIENCEMidwest Vision Partners, Chicago, Illinois March 2022 June 2024 Manager Credentialing & Payer Enrollment Managed team of six payer enrollment specialists Coordinated and lead staff on workflows, spreadsheets, and credentialing databases Trained and mentored employees conducting weekly sessions Conducted performance improvement plans and annual performance reviews Provider Enrollment (Medicare, Medicaid, Workers Compensation and Commercial plans for multiple states in the Midwest Region) Primary liaison for practices, clinics, payers, revenue cycle management, billing and practitioners Primary contact for onboarding; developed onboarding process when none existed CAQH development and maintenance Verifications of credentials and importing to database Auditing of database Point of contact for escalated issues involving payer enrollment to the C-Suite, Regional Directors and Practice Managers Primary person responsible for initiating appointment applications and reappointments for Medical Doctors with various hospitals and surgical centers across the Midwest Region. Naples Community Hospital & NCH Healthcare System January 2021 February 2022 Manager Credentialing Managed team of four credentialing specialists and one credentialing assistant for an acute care hospital Coordinated and monitored the accreditation, credentialing, privileging and re-credentialing processes Collected, verified and processed all new Medical Staff and Allied Health Professional practitioner applications and reapplications and privileging Meeting management coordinated, prepared, and oversaw all medical staff meetings, committee meetings, including Medical Executive Committee (MEC); attended and prepared meeting minutes and materials utilizing PowerPoint providing executive assistance to the Chief Medical Officer and President of the Medical Staff. Prepared reports to medical staff departments, committees, peer review panels, Medical Executive Committee (MEC), General Staff Meetings, Administration and Boards Managed the credentialing database system to ensure all updates are made accurately Project Manager for developing and implementing a robust onboarding process for Physicians and Allied Health Professionals where none existed Reviewed and updated as necessary standardized credentialing forms and delineation of clinical privilege forms and proctoring protocol and bylawsCandidate's Name
1846 Sunhollow CourtHaslett, MI 48840PHONE NUMBER AVAILABLEEMAIL AVAILABLEPage 2 of 2 Participated in the Joint Commission audit as well as managed care audits. Long Beach Memorial Hospital & Millers Womens and Childrens Hospital August 2015 January 2021 Executive Assistant Medical Staff Services & Patient Quality Provided executive assistance to the Chief Medical Officer, Chiefs of Staff, Chief Quality Officer and Director of Medical Staff Services for acute care hospital and specialty hospital for Women & Children. Meeting management included scheduling, coordinating in all specialty areas, preparing meeting materials and facilitating for various committeesMedical Executive CommitteeCredentialing CommitteeQuality Review and Performance ImprovementPatient Safety & Risk ManagementCulture of SafetyMedical ProfessionalismBioethicsPolicy & Procedure Manual ReviewMedical Staff Annual MeetingLeadership ConferencesMedical Staff Orientation Prepared reports to medical staff departments, committees, peer review panels Managed the credentialing database system to ensure all updates are made accurately Project Manager for developing and implementing a robust onboarding process for Physicians and Allied Health Professionals where none existed Reviewed and updated as necessary standardized credentialing forms and bylaws ADDITIONAL QUALIFICATIONSSoftware / Technology Proficiency Medallion, MDStaff, MDAccess, Echo, Credential Stream Microsoft Office Outlook, Word and ExcelGoogle DocsPowerpoint, Adobe, VisioEducation Lansing Community College 30 credits Business Administration Mason High School, Mason, MICertifications / LicensureUniversity of Michigan - LEAN Process ImprovementMemberships / Associations Member of NAMSSOther25 years Human Resources Experience |
