About The Position

Utilizing independent critical thinking and problem-solving skills, responsible for administering, coordinating and maintaining Medical Staff services related to credentialing, re-credentialing, provider on- and off-boarding, and clinical department and committee operations and projects. Ensures accurate interpretation and compliance with appropriate accreditation and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws related to assigned Medical Staff processes. Responsible for maintaining the accuracy and the integrity of department records, databases and systems. Proactively communicates with providers, internal stakeholders, and colleagues to ensure a high-level of customer service is provided.

Requirements

  • H.S. Diploma or Equivalent
  • 3 Years progressively responsible experience in healthcare environment (experience to include, but is not limited to: meeting coordination and transcribing minutes, communicating with varying levels of personnel both verbally and in writing, and working in a confidential environment).
  • Basic knowledge of medical terminology is required.
  • Knowledge of Medical Staff Bylaws, JCAHO, CMA and Title 22 is preferred.

Nice To Haves

  • Associate's Degree
  • Coursework in healthcare administration
  • 1 Year experience related to credentialing or medical staff operations.
  • Experience with Physician databases.
  • Certified Professional Medical Services Management (CPMSM) - National Association Medical Staff Services -PREFERRED
  • Certified Provider Credentialing Specialist (CPCS) - National Association Medical Staff Services -PREFERRED

Responsibilities

  • Coordinates and supports Medical Staff committee meetings and departments.
  • Compiles accurate agendas, including coordination with committee chairs and members and appropriate hospital staff.
  • Accurately documents and submits committee and department activity, including meeting minutes, reports, pending action actions, and correspondence according to committee guidelines and timelines.
  • Serves as a technical advisor to related committee department chairs, provides information required at committee meetings, and updates committee members on their responsibilities with associated requirements.
  • Maintains and applies knowledge of Medical Staff Bylaws, JCAHO, CMA and Title 22 and other regulatory/legal requirements.
  • Apprises and updates department, committee chairs, and other Medical Staff stakeholders of key updates and their responsibilities in accordance with these requirements.
  • Ensures compliance with regulatory and department requirements in all work product and recommendations.
  • Maintains annual review records of policies, procedures, privilege forms, departmental rules and regulations, etc.
  • Initiates, coordinates, monitors, and completes tasks to facilitate full life cycle medical staff services related to provide on- and off-boarding.
  • Initiates timely review and completion of all associated tasks to ensure eligibility and a complete provider file for credentialing and privileging, including background investigation, primary source verification of all components, follow up of quality and/or peer reviews, and proctor/monitor the process.
  • Proactively monitors reporting tools, validate discrepancies, ensures follow-up and completion of requisite tasks to ensure all credentialing or re-credentialing tasks are completed on-time.
  • Initiates and responds to requests from internal and external customers and stakeholders and works collaboratively across the team.
  • Organizes workflow based on department priorities and proactively communicates and problem solves to a smooth, timely and service-oriented credentialing experience.
  • Maintains database to assure information is accurate and current.
  • Participates in the annual review process; compiles and analyzes qualitative and quantitative data to identify trends and recommends solutions to management.
  • Identifies gaps/pain points in department processes and operations through critical thinking and by soliciting recommendations from department chairs and committee members and recommends solutions to management.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

High school or GED

Number of Employees

5,001-10,000 employees

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