Director, Medical Staff Relations
at Northbay Healthcare

Date Posted: 1/2/2019

Job Description


Director, Medical Staff Relations

Full Time, FTE: 1
NorthBay Medical Center
Fairfield, CA

Job Summary:

This Director is accountable for the management, coordination, and supervision of all activities within the following departments: Medical Staff Office and libraries for NorthBay Healthcare Group which includes the Hospitals, Medical Practices/Group, and the free standing Ambulatory Surgery Center. This includes oversight of the medico-legal aspects of the medical staff service, and compliance with accreditation and regulatory requirements (i.e., The Joint Commission (TJC), Accreditation Association for Ambulatory HealthCare Inc. (AAAHC), National Committee on Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), Institute for Medical Quality (IMQ), and the California Department of Public Health (CDPH) in regards to medical staff functions. Responsible for coordination and oversight of the Medical Staff Services Department, including physician and allied health practitioner credentialing and re-credentialing, , focused professional practice evaluation management, meeting management, flow of information from medical staff committees through the Medical Executive Committee, Medical Practices Credentialing Peer Review Committee, Medical Advisory Committee, Operating Committee and/or the Governing Board as appropriate. Maintains a working knowledge of the medical staff bylaws, rules and regulations, and policies and keeps the medical staff updated on all changes. Responsible for establishing, contributing to, and maintaining continuity in the development, and implementation of standards and regulations applicable to the medical staff, related to credentialing, quality, and administrative functions. Provides consultative expertise to the medical staff and administration on options and actions to meet those standards. Develops and maintains the Continuing Medical Education program to include compliance with accreditation requirements.  Responsible for budgetary management.  Provides supervisory oversight of the Medical Services staff to achieve meeting the mission, vision, and goals of NorthBay Healthcare Group. 

Education and Certification:

  1. Bachelor Degree in healthcare or business related field required, or certification with
    seven years of experience in medical staff office with progressive responsibility in leadership.  Master Degree preferred.

  2. Certified Professional Medical Services Management (CPMSM), preferred.  Must obtain within 3 years of hire.


  1. Four years of experience in managing/directing a Medical Staff Services, Quality, or similar department. Continuing Medical Education (CME) program experience, to include maintenance of education program, and compliance with CMA/IMQ Accreditation requirements, preferred.
  2. Continuing Medical Education (CME) program experience, to include maintenance of education program, and compliance with CMA/IMQ Accreditation requirements, preferred.


  1. Demonstrates excellent oral and written communication skills.
  2. Must possess leadership ability and high professional standards. 
  3. The NorthBay Way is a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at NorthBay Healthcare. The NorthBay Way principles consist of Caring, Communication, Collaboration, and Competence. 
  4. Must have strong computer skills, experience with Word and Excel programs.  Strong database skills.
  5. Ability to organize, prioritize, and manage multiple tasks and projects and follows through to ensure tasks and projects are completed.
  6. Strong attention to detail and considerable concentration skills.
  7. Ability to handle confidential information, as appropriate.
  8. Ability to use initiative and judgment when making decisions.
  9. Must be customer-focused.
  10. Strong knowledge of regulatory process required (TJC, NCQA, AAAHC, CDPH, IMQ, CMS)


Job Snapshot

  • Employee Type: Full-Time
  • Location: Fairfield, CA
  • Job Type: Health Care
  • Experience: Not Specified
  • Date Posted: 1/2/2019

About Us

At NorthBay Healthcare, we are committed to upholding the health, wellness, and vitality of the California community members throughout Solano County and beyond. Tracing our roots back to 1960, we are the area’s only locally-based, locally-managed non-profit healthcare organization. Our presence as a leader in innovative healthcare solutions is made possible by a talented team of professionals who enjoy making a difference as well as a living. We call it “The NorthBay Way.” The principles that lead our work include:

  • Caring– be friendly, be helpful; treat others in the way they want to be treated. Be compassionate; demonstrate genuine concern for the well-being of others. Affirm the worth and potential of others, and encourage caring behaviors.
  • Collaborationhonor promises and commitments; work in a spirit of cooperation. Establish and maintain healthy interpersonal relationships. Appreciate and use the knowledge and experience of others; fully support decisions once they are made. Be fair, be equitable, and be aware in all actions affecting others.
  • Communication be consistent; earn and maintain the trust of others. Listen first; strive to understand events as they have meaning to others. Provide frequent, direct, and truthful communications. Ensure a clear and compelling purpose for the work that needs to be done. Show appreciation, recognize results, and celebrate accomplishments.
  • Competence – take personal responsibility for uncompromising levels of service, quality, and safety. Be accountable for problems that cross your path: do whatever it takes to do the right thing. Manage resources with prudence and responsibility; encourage innovation and risk-taking in others. Engage in lifelong learning to grow more skilled, professionally and personally.

We are pleased to present a variety of impactful, rewarding career positions for individuals with a variety of professional skills, goals, and experience – including clinical nurse specialists, computer systems analysts, medical and health services managers, nurse practitioners, registered nurses, and more. Join the NorthBay Healthcare Talent Network today to stay up-to-date on our openings as they continue to become available!

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