Medical Staff Administrator- St. Anne Hospital

Mercy Health • Toledo, OH

8d • Onsite

About The Position

Thank you for considering a career at Mercy Health! Scheduled Weekly Hours: 40 Work Shift: Days (United States of America) Location: St. Anne Hospital Shift: Days/Full-time SUMMARY: The Credentialing Auditor will provide operational oversight for the quality and audit function of all Centralized Verification Office (CVO) credentialing and credentialing files to ensure the accuracy and completeness of verifications done by the CVO. The Credentialing Auditor will be responsible for credentialing and re-credentialing regional providers for hospital privileges and preparing files before review by Medical Staff Leaders and sending to the regional Medical Staff Offices. The Credentialing Auditor will work in collaboration with the Regions Medical Staff Office Professionals to provide support for those functions that impact the multiple facilities within the region.

Requirements

• Required: 2/year Associate degree or equivalent combination of related education. Combination of post-secondary education and experience will be considered in lieu of degree.
• Required: Certification by the National Association Medical Staff Services as either a CPCS or CPMSM or become certified within 3 years of employment.
• Minimum Years and Type of Experience: A minimum of at least 5 years’ experience in a central verification office, hospital or managed care setting.
• Other Knowledge, Skills and Abilities Required: Knowledge of the acute care/hospital credentialing process including initial appointment, privilege, delineation and reappointment; Knowledge and experience in medical/legal issues and laws, and regulatory requirements (TCJ, CMS); Strong computer skills including knowledge of Cactus Software credentialing system; Strong organizational skills with required attention to detail; Ability to solve problems and resolve conflicts; excellent oral and written communication skills; Excellent interpersonal skills and ability to work effectively and efficiently with others; Ability to work independently; Ability to maintain confidential information and exhibit a professional appearance and demeanor; ability to travel.

Nice To Haves

• Preferred: Proficiency with offices software applications (Microsoft Office Suite) ; presentation skills and strong time management skills.

Responsibilities

• Audits 100% of credentialing and re-credentialing files submitted by the Credentialing Specialists for accuracy and completeness.
• Obtains additional information as necessary to complete the file on behalf of all Mercy North region hospitals.
• Returns audited files for corrections to the relevant Credentialing Specialist for the purposes of data correction and education.
• Prepares credentialing and re-credentialing files for electronic file review with the Medical Staff Leaders and meets one-on-one with Metro Leaders, if requested.
• Prepares Credentialing Report for the Regional Medical Staff Offices to include on their Committee Meeting Agendas and is available to participate in the Credentials Committee meetings, if requested.
• Develop, implement, and maintain Credentialing audit tools annually to ensure compliance with current Joint Commission, State, and Federal Requirements.
• Works closely with Regional Director to meet the educational needs of the Credentialing/Medical Staff Specialists and provides in-service/orientation/education as needed.
• Assist with all regulatory, state and federal surveys as requested.

Benefits

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HAS/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support
• Benefits may vary based on the market and employment status.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees