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Kaiser Permanente Careers

Quality Assurance, UR & Case Management

Passion + Vision + Integrity = Excellence

Ensure consistency and the highest ethical standards across our entire organization. Our quality assurance team drives ongoing improvement by fostering an environment of support, providing technical and specialized consultative services, and inspiring ongoing excellence.

Manager, Medical Staff Services

Location: Walnut Creek, CA Additional Locations:
Job Number: 825892 Date posted: 10/26/2019

Responsible for the overall management of the medical staff services functions, including staffing, confidential practitioner database administration, survey preparation/coordination, credentialing, privileging, bylaws, rules and regulations, policies, procedures, focused and ongoing professional practice evaluation, committees and communications, CME, GME.

Essential Functions:
- Plans, directs, manages and monitors the day-to-day work activities of the Medical Staff Office, CME and GME, including budget management, workplace safety, and equipment management.
- Manages thecredentialing/recredentialing, proctoring, privileging and reappointment process for Licensed Independent Practitioners (LIPs) and Allied Health Professionals.Coordinates to ensure that credentials documents are complete prior to local approval process.
- Coordinates reappointment process to ensure that required data and documents for reappointment (OPPE, peer review, focused practice review) are produced and available for Medical Staff and committee review.
- Provides consultation and ensures compliance in regards to bylaws, regulatory, legal, and accreditation, medical staff standards. Participates in accreditation survey readiness activities (NCQA, Joint Commission, MediCal).
- Develop and implement systems and processes that meet requirements and adhere to Regional and Medical Center Credentialing Policies and Procedures in collaboration with internal stakeholders.
- Manages processes for assessing professional staff license and certification expirations, and implements suspension processes consistent with organizational policies.
- Acts as a liaison, technical advisor, and resource person for the professional and allied staff, administration within each site. Interprets requirements and disseminates information to all involved parties to assure necessary compliance, compatibility and continuous quality improvement of the credentialing process.
- Collaborates with the Chiefs of Medical Staff Departments and functions to ensure compliance with by laws. Provides orientation and training to newly appointed physician leaders for effective oversight and management of their departments credentialing, proctoring, privileging and reappointment processes.
- Coordinates with KP Legal counsel when legal actions require the production of credentialing and privileging documents.
- May provide managerial support and assistance for staff supporting Continuing Medical Education (CME) and Graduate Medical Education (GME) functions. Ensures systems and process are established to support ongoing regulatory compliance.
- Ensures systems and process are established to support ongoing compliance with ACGME standards.
- Coordinates the support for Medical Staff committees as assigned.
- Manages thehuman resource functions for hiring, training, evaluation and counseling staff, and assessing quality of service provided to key stakeholders.

Basic Qualifications:
- Minimum five (5) years of experience in health care in an administrative or managerial position related to credentialing and/or accreditation.
- Minimum two (2) years of supervisory experience.
- Bachelor's degree required, OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A.
Additional Requirements:
- Proficient use of computer based medical staff programs, databases and Microsoft office programs (i.e.Word, Excel)
- Excellent written, verbal communication, organizational and strong interpersonal skills required.
- Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:
- CPCS (Certified Provider Credentialing Specialist) and/or CPMSM (Certified Professional Medical Services Management) certificates.

Primary Location: California,Walnut Creek,Walnut Creek Stanwell Building 1630 Newell Ave. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 8:00 AM Working Hours End: 4:30 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Manager with Direct Reports Job Category: QA / UR / Case Management Department: Medical Staff Office Travel: Yes, 10 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

About QA, Ur & Case Management Careers

Careers In QA, Ur & Case Management

As an organization, we are committed to delivering the same exemplary care no matter who you are, where you are, or what your needs. But how are those standards defined, measured, and assessed? That's where our quality assurance team comes in. Implementing the action plans and initiatives that will drive successful practices, you'll work across the organization to foster the necessary education, communication, and innovation that will enable us to operate as one KP — with our mission and goals in complete alignment.

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Mar 26, 2019

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