Lore Reed Email & Phone Number

Manages, plans, organizes and directs the day to day operations of the Medical Staff Office (MSO) including staff oversight* Development of annual operation budgets and provides direction for the allocation of said budget* Coordinate and integrate services within the department as well as with other departments and facilities* Manage Initial and Reappointment of Medical Staff (Credentialing and Privileging) for 251 providers at multiple facilities to ensure timely processing based on CMS, Joint Commission, NCQA and state regulations* Manage Provider Enrollment for the Providers and all OSS Facilities* Manage Delegated Contracts and Auditing of Files for Commercial Payers* Manage the onboarding of new practices and physicians as it pertains to credentialing, privileging and enrollment of providers and location in commercial, Medicare and Medicaid products.* Oversight Management of Peer Review Data Collection for FPPE and OPPE* Maintains the confidentiality and integrity of the provider's electronic credentialing files at all times* Management of quality control of all Medical Staff Services operations* Management of Initial Specialty Board Certifications and MOC processes for all physicians in our provider group* Develops and maintains all MSO applications, bylaws, documents and Policy and Procedures for multiple facilities* Complies with all regulatory standards, providing consultative expertise to the Hospital Leadership team, MSO and other departments as applicable on options and permissible actions in order to meet those standards* Assist the patient financial team with Claims denial resolution as it relates to enrollment issues* Manage the maintenance of providers in PECOS and DHS sites for Medicare and Medicaid* Manage the maintenance of provider information in the CAQH database

* Plans, organizes and directs the day to day operations of the Medical Staff Office (MSO) including staff oversight* Development of annual operation budgets and provides direction for the allocation of said budget* Coordinate and integrate services within the department as well as with other departments and facilities* Manage Initial and Reappointment of Medical Staff (Credentialing and Privileging) for 251 providers at multiple facilities to include OSS Health, Geisinger Holy Spirit, Health South Rehab, UPMC Pinnacle Hanover Hospital, UPMC Pinnacle Memorial Hospital, and Wellspan York Hospital ensuring timely processing based on CMS, Joint Commission, NCQA and state regulations* Manage Provider Enrollment for the Providers and all OSS Facilities* Manage Delegated Contracts and Auditing of Files for Commercial Payers* Manage the onboarding of new practices and physicians as it pertains to credentialing, privileging and enrollment of providers and location in commercial, Medicare and Medicaid products.* Oversight of Peer Review Data Collection for FPPE and OPPE* Maintains the confidentiality and integrity of the provider's electronic credentialing files at all times* Ensures quality control of credentialing, privileging and enrollment operations* Coordinates and oversees Initial Specialty Board Certifications and MOC processes for all physicians in our provider group* Develops and maintains all MSO applications, bylaws, documents and Policy and Procedures for multiple facilities* Complies with all regulatory standards, providing consultative expertise to the Hospital Leadership, MSO and other departments as applicable on options and permissible actions in order to meet those standards* Assist the patient financial team with Claims denial resolution as it relates to enrollment issues* Maintain Providers in PECOS and DHS sites for Medicare and Medicaid* Maintain Provider information in the CAQH database

Policy & Procedure Development, Maintenance and Compliance with TJC and DOH regulationsCoordinated Business Meetings and PresentationsCoordinated Travel ArrangementsSupported the VPMA, CNO, COO and Controller

Created daily, weekly and monthly activity calendar for the entire facility.Participated in Care Planning and Family MeetingsChart documentationInteraction with all residents to get them involved in activities outside of their rooms.Budget Maintenance