Coordinator Credentialing

American Addiction Centers•Hazel Crest, IL

5d•$25 - $38•Hybrid

About The Position

The Coordinator Credentialing is responsible for coordinating and facilitating medical staff and advanced practice professional credentialing and privileging. This role involves critically analyzing data to make informed recommendations for credentialing, re-credentialing, and privileging, ensuring adherence to accreditation standards, state and federal law, and Medical Staff bylaws. The coordinator will verify and analyze practitioner-specific data, identify, review, and report on practitioner performance data, complaints, sanctions, and quality of care issues. They must maintain continuous knowledge of and adherence to regulatory requirements, accreditation standards, Medical Staff Bylaws, and organizational policies. Additionally, the role involves coordinating survey preparation for regulatory surveys and audits, reviewing and implementing new rulings, and developing/enforcing Medical Staff bylaws, rules, regulations, and policies. The coordinator also manages the onboarding and orientation of new practitioners, ensures accurate entry of privileges, arranges authorization processes, and makes necessary system entries for practitioner activation and inclusion in reports. They are responsible for creating monthly reports for Governing Bodies and collaborating with the quality management department on quality data for FPPE and OPPE processes. The role also involves researching and recommending FPPE criteria, ensuring new applicants undergo FPPE, and collaborating with Department Chiefs and Section Chairs to review OPPE data. Finally, the coordinator serves as a liaison between the medical staff, administration, ancillary departments, and patients, and establishes systems to facilitate committee meetings and communication for the Medical Staff governance structure.

Requirements

High School Graduate
Typically requires 3 years of experience in a health care setting that includes experiences in privileging and credentialing processes.
Proficient in the use of Microsoft Office (Excel, Access, PowerPoint and Word)
Maintain upward communication with leadership regarding development within areas of assigned responsibilities and perform special projects as required or requested.
Ability to represent the department effectively with supporting teams.
Demonstrate problem solving, critical thinking, and process analysis skills to support teams.
Possess willingness to learn and develop understanding of configuration best practices.
Willingness to escalate issues that may impact team productivity or confusion on priorities.
Strong knowledge of medical terminology.
Excellent communication, organizational and problem solving skills.
Must have proven track record of effective interactions with physicians and other health care professionals.
Ability to work effectively with minimal supervision and manage multiple priorities.
Must hold a valid driver's license and be willing to travel between Metro Region Hospitals as needed.

Nice To Haves

Some schedule flexibility for medical staff events or off shift meeting times.

Responsibilities

Coordinates and facilitates medical staff and advanced practice professional credentialing and privileging at the time of initial appointment and biennial reappointment.
Critically analyzes data to create informed recommendations for credentialing, re-credentialing, and privileging for Medical Staff leaders and committees, ensuring adherence to accreditation standards, state and federal law, and Medical Staff bylaws.
Verify and analyze practitioner-specific data obtained during the credentialing and privileging for approval bodies.
Identify, review and report practitioner performance data, complaints, sanctions, adverse actions, and quality of care issues in order to facilitate analysis and evaluation of current/ongoing practitioner competency by approval bodies, including Credentials Committee, Medical Executive Committee, and Governing Bodies.
Ensures continuous knowledge of and adherence to regulatory requirements, accreditation standards, Medical Staff Bylaws and Medical Staff and organizational policies and procedures.
Ensures all practices and procedures are in accordance with Det Norske Veritas (DNV), The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), Healthcare Facilities Accreditation Program (HFAP), Emergency Medical Treatment and Labor Act (EMTALA), Healthcare Quality Improvement Act (HQIA), National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), State law, Medical Staff bylaws and hospital and system-wide policies.
Responsible for coordination of and survey preparation for all Medical Staff matters for regulatory surveys and audits.
Reviews and implements new actions related to federal and state rulings and accrediting body standards pertaining to the functions of the Medical Staff.
Develops, establishes, and enforces Medical Staff bylaws, rules and regulations, and policies that govern the activities of the Medical Staff and coordinates the activities of the self-governing organized Medical Staff.
Coordinates and manages the onboarding and orientation of newly appointed practitioners to the Medical Staff, including development, implementation, and maintenance of the regulatory and legally required education.
Ensures accurate entry of privileges, arranges authorization processes to allow practitioners electronic medical record access, makes all appropriate entries into applicable systems to activate the practitioner and ensure practitioner inclusion in rosters, directories, and reports.
Responsible for creating monthly reports for the Governing Bodies on credentialing and privileging, and other Medical Staff actions and matters.
Collaborates with the quality management department to develop and distribute quality data for the Focused Professional Practice Evaluation (FPPE) process and the Ongoing Professional Practice Evaluation (OPPE) according to regulatory requirements.
Researches and recommends FPPE criteria and ensures that all new applicants undergo FPPE within established timeframes, following up with proctors and/or reviewers as necessary.
Collaborates with Department Chiefs and Section Chairs to review OPPE data.
Serves as a liaison between the medical staff, administration, ancillary departments and patients.
Establish and maintain systems to facilitate committee meetings and communication for the Medical Staff governance structure, adhering to Robert’s Rules of Order, including with Medical Staff leaders and members, departments and sections, and hospital administration.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program