Project Manager - Integrated Credentialing - Full Time 8 Hour Days (Exempt) (Non-Union)

The Program Managers is responsible for the fulfillment of organizational programs by coordinating activities in order to execute quality and improvement programs. They will provide strategic guidance to teams and program stakeholders and will oversee the progress of program operations. They are responsible for management of the program, giving detailed attention to strategy, project delegation, and program implementation. The position also assists in the deployment of support tools and ensures that they are effectively used on an operational basis. Manage communication, program roll out and program facilitation as assigned.

Departmental Specific Summary

The Program Manager, Office of Integrated Credentialing manages credentialing programs and projects across Keck Medicine of USC which provides system-wide primary source verification information to hospitals for USC clients Medical Staff practitioners including initial applications, reinstatements, and reappointments. The Program Manager provides leadership and oversight over projects in his or her functional domain and serves as a mentor. The Program Manager is responsible for managing multifaceted and multidisciplinary credentialing programs and projects ensuring scope is delivered according to deadlines, budget, and quality industry standards. The Program Manager collaborates with the Medical Staff Services Offices, business entities, and Health System functions of Keck Medicine of USC to develop effective credentialing policies, procedures and processes and implements applicable policies and processes within OIC. Ensures compliance with regulatory requirements related to credentialing (such as TJC, DNV, NCQA, AAAHC, Title 22, CMS, OIG, MBC and NPDB). The Program Manager develops project plans, builds project schedules, manages project meetings, communicates progress and status, enforces quality management, and identifies, responds, and manages issues, and changes and manages all applicable quality improvement project activities and ensures all project phases are documented appropriately. The Program Manager scope includes responsibility for the Keck Medicine of USC system-wide provider database including establishment of a system-wide data dictionary, user training within OIC and throughout the Keck Medicine of USC system (i.e. Medical Staff Services Offices) as appropriate, for sharing of appropriate database information with Health System departments and systems, and interfacing with IT for software upgrades and maintenance. Responsible for establishing productivity standards. The Program Manager is responsible for medical staff office activities of USC Care Medical Group that include delegated credentialing oversight and coordination of delegated activities, to include proctoring and peer review. Serves as committee support.

Essential Duties

• Creates and executes project plans and revises appropriately to meet changing requirements and needs. Plans and schedules project timelines and milestones using the appropriate tools. Ensures that project documents are current and complete, as well as appropriately managed and stored. Helps prepare institution for site visits/audits/surveys and coordinates internal review process Manages and coordinates USC Care health plan credentialing audits, routine health plan updates, as well as medical group privileging and peer review activities Demonstrates excellent interpersonal skills necessary for effective collaboration with individuals across all levels of the Health System Monitors for changes in standards and adjusts practices accordingly Audits credentials files for accuracy/quality/completeness prior to submission to clients/Integrated Credentials Committee. Measurement: Supervisory observation, management/staff feedback and survey results. Expiring document system is maintained, practitioners are alerted to expirations which effect their Medical Staff membership or privileges well in advance of the expiration. Staff ensures provider follow though as appropriate including requesting assistance from Medical Staff Offices if needed. Facilities are alerted in advance to assure they have adequate time to rectify records and maintain compliance Maintenance of credentialing delegated status with health plans
• Manages day-to-day operational and tactical activities of a project. Develops and delivers progress reports, proposals, requirements documentation and presentations. Diagnoses task/procedural change issues and helps to resolve the problem. Proactively manages changes in project scope, identifies any potential crisis or issues and devises contingency plans to mitigate concerns. Maintains data dictionary for the Keck Medicine of USC provider database. Establishes and implements audit criteria for key fields and data, including those that are exported for use as key data elements in other systems (IDX Last Word for example). Participates and coordinates with corporate staff as appropriate in the identification and subsequent routine collection of data and associated standard and ad hoc reporting for organizational planning and strategic purposes. In the role of “master user” ensures users in OIC, in the medical staff offices and other appropriate users of ECHO are trained on using the centralized provider database for appropriate MD-Staff functions including running reports (standard and ad hoc as needed). Develop proficiencies in advance applications (for example, ad hoc reports) of MD-Staff as needed to meet especially data reporting needs of corporate functions. Maximizes the use of MD-Staff, within any budget constraints, to streamline OIC functions and communication with Medical Staff Services Offices. OIC staff is responsible for timely and accurate entry of all data and the associated quality except for facility specific information. The database is maintained to be secure and confidential. Only authorized persons have access to the system. Measurement: Data in MD-Staff routinely passes audit criteria. Users of MD-Staff have through training on appropriate functions. Corporate users of MD-Staff data experience timely availability of needed data reports. Supervisory observation
• Develops a cohesive, collaborative relationship with the Manager of the OIC, Medical Staff Services Directors/Managers, OIC staff, and other users of the Office of Integrated Credentialing and USC Care Medical Staff Office, along with other system colleagues. Develops and writes policies and procedures related to the credentialing process, which each facility and the Board approves. Maintains a Policy and Procedure Manual related to OIC, credentialing and USC Care medical staff office processes. May coordinate other credentialing processes as identified by facility Medical Staff Services Offices or other OIC customers. Measurement: Supervisory observation including feedback from MSO Management Teams and other customers.
• Formally evaluates staff. Writes and /or conducts annual performance reviews. Promotes customer and team focused solutions within staff. Conducts coaching/ counseling/ corrective action included pertinent documentation. Gathers and evaluated facts. Identified and resolved problems. Interprets, communicated and applied appropriate policies, procedures and practice in a confidential manner. Maintains staff productivity standards. Measurement: Timely performance review conducted. Other pertinent documents submitted to HR. Staff productivity are at or above standards and staff is self-directed. Supervisory observation Understands how to communicate difficult and sensitive information tactfully. Effectively communicates relevant project information to leadership.
• Participates effectively in site, organization, and/or system-wide improvement projects. Develops department-specific customer service survey. Acts as committee support backup. Measurement: Supervisory observation, management/staff feedback, and survey results.
• Perform other duties as assigned or requested.

Qualifications

• Req Bachelor's degree Degree in a related field
• Pref Master's degree Degree in a related field

• Bachelor’s degree in healthcare administration or related field required. • Combined Experience/Education may substitute for Education requirement

• Req 3 years Experience with Medical Staff services/credentialing.
• Pref Health plan audit experience preferred.
• Pref Health System/CVO experience preferred.
• Pref Diligence experience preferred

• Req Ability to develop and integrate organizational programs
• Req Confidentiality in managing sensitive issues and information
• Req Proven ability to lead organizational change initiatives
• Req Advanced skills in building effective working relationships
• Req Strong influencing and negotiation skills
• Req Exceptional skills in leading and motivating others, managing conflict and creating a climate of collaboration and trust
• Req Ability to work effectively across all levels of the organization
• Req Excellent analytical and conceptual thinking skills
• Req Thorough understanding of process improvement methodologies, continuous quality improvement and fiscal management
• Req Ability to facilitate working sessions with large, cross-functional, multidisciplinary teams
• Req Ability to present to and manage communication with quality and hospital executive leadership
• Pref Working knowledge of MD-Staff credentialing solution
• Pref Familiar with lean process improvement techniques: business (Six Sigma,)
• Pref Proficiency with MS Office (Including Word, Excel, Outlook, PowerPoint, Access)

• Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)
• Req Certified Professional in Medical Services Management (NAMSS) Certified “Certified Professional Medical Services Management” (CPMSM) by the National Association Medical Staff Services (NAMSS) or NAMSS “Certified Provider Credentialing Specialist” (CPCS) required. If no current certification, must obtain within one (1) year of hire.

USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position for which you are applying. 

We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at uschr@usc.edu. Inquiries will be treated as confidential to the extent permitted by law.

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