The Tomorrow’s MSP® core functional areas and skillsets outline the responsibilities necessary for MSPs to perform their jobs, provide context for career advancement in the profession, and set a clear direction for the future of the medical services profession.
Core Functional Areas
Manages Provider Enrollment Process
|
Example: Maintains provider enrollment information within the credentialing database and pulls reports for hospital administration, marketing, professional billing staff, and clinic directors/managers as needed.
|
Analyzes and Manages Data Verification
|
Example: Identifies associations between seemingly independent problems or events to recognize trends, problems, and possible cause-effect relationships.
|
Manages the Credentialing or Privileging Process
|
Example: Evaluates credentialing/privileging requests and evidence of education, training, and experience to determine eligibility for requested privileges, membership, and/or plan participation.
|
Conducts, Participates In, and Maintains Credentialing and Privileging
|
Example: Compiles, evaluates, and presents the practitioner-specific data collected for review by one or more.
|
Conducts, Participates In, and Maintains Current Clinical Competency Evaluations and Peer Reviews
|
Example: Recognizes, investigates, and validates discrepancies and adverse information obtained.
|
Complies with Accreditation Standards and Regulatory Standards
|
Examples: 1). Participates in surveys and audits of regulatory and accreditation agencies or organizations. 2). Obtains and evaluates practitioner sanctions, complaints, and adverse data to ensure compliance.
|
Manages Compliance with State and Federal Accreditation Standards and Regulatory Requirements
|
Example: Develops and/or updates applicable governing documents (bylaws, rules and regulations/policies and procedures) that support and direct organizational practices and ensure compliance.
|
Conducts, Participates In, and Maintains Primary Source Verification
|
Example: Verifies and documents expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
|
Manages Departmental Operations
|
Example: Verifies and documents expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
|
Facilitates Medical Staff Functions
|
Example: Collaborates with executive teams to integrate operational needs into strategic planning processes and promotes practitioner advocacy, departmental effectiveness, and regulatory readiness.
|
Skillsets
|
Analytical Thinking
|
Information Technology
|
Relationship Building
|
|
Budget/Finance
|
Legal
|
Risk Management
|
|
Change Management
|
Managed Care
|
Team Building
|
|
Clinical Competence
|
Performance Improvement
|
Database Management
|
|
Communication
|
Political Savvy
|
Medical Staff Professionalism
|
|
Confidentiality
|
Presentation Skills
|
Medical Staff Wellness
|
|
Contracting
|
Professional Ethics
|
Continuing Medical Education
|
|
Evaluation
|
Professional Presence
|
Medical Staff Bylaws & Policies/Procedures
|
|
Flexibility/Adaptability
|
Project Management
|
Remote People Management |
|
Human Resources
|
Quality Review/Quality
|
|