Credentials Evaluation Analyst
2 weeks ago
Align yourself with an organization that has a reputation for excellence Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have high levels of employee engagement. We provide an outstanding benefit package that includes healthcare and a 403(b), along with competitive compensation. Join us Discover why U.S. News & World Report has named us one of America’s Best Hospitals.
**What Will I be Doing in this Role?**
The Credentials Evaluation Analyst provides guidance and support to medical staff leadership in the evaluation of credentials and practice information as it relates to the granting of clinical privileges. Contributes to the planning, structuring and monitoring of credentialing activities, and assists with high-profile/sensitive credentialing projects. Works in collaboration to implement standard processes, recommend policy/procedure changes and provide input about work products.
Collaborates with Credentialing Logistics and Information Department - Evaluates individual practitioner credentials files (both electronic and paper files) to ensure that information received from the Credentials Coordinators/Credentials QC Analysts meets established specifications. Pursues additional information as necessary. Investigates issues of concern in cooperation with applicable individuals and/or departments.
Advances and makes recommendations to resolve issues that do not conform to established expectations to Credentialing Manager or consultation with other appropriate partners, as required.
Identifies/Flags Potentially Adverse Information - Assesses practitioner files to determine the presence or absence of potentially adverse or incomplete information that may impact medical staff membership or privileging decisions in accordance with established criteria. Pursues problematic, missing or incomplete information in conformance with established procedures. Summarizes the results of the assessment in the file audit summary report.
Evaluation of Credentials /Qualifications Against Privileging Criteria - Assesses data/information provided against criteria for privileges requested and recommend actions for resolution. Pursues problematic, missing or incomplete information in conformance with established procedures. Summarizes the results of the assessment in the file audit summary report.
Communication - Maintains lines of communication on work products and evolving issues of concern with regard to applicants/re-applicants with medical staff leadership, Credentials QC Analysts/Coordinators, clinical department managers and Clinical Privileging Quality Manager, as applicable.
Interview Coordination - Coordinates completion of interview for initial applicants. In accordance with the New Applicant Work Process (Jobs & Tasks) conducts follow-up as prompted by task list. Follows-up with interviewer to facilitate completion of Interview Summary & Recommendation form. Coordinates any additional follow-up necessary to resolve areas of concern.
Support of Practitioner Evaluation - Serves as a liaison and provides support for the divisional review, department chair review and pre-Credentials Committee review (as applicable) of both initial applicants and applicants for renewal. Facilitates a detailed and comprehensive evaluation as related to granting, continuing, denying or rescinding privileges.
Collaboration with Patient Safety and Peer Review Department - Collaborates with applicable individuals regarding related competency management activities associated with Ongoing Professional Practice Evaluation (OPPE) to promote the identification of professional practice trends that impact quality of care and patient safety. Ensures that the results of these evaluations are considered by division chiefs and department chairs when recommendations regarding continued privileging occur. Sends notification of conditional appointments/privileges to Quality Improvement department and tracks for compliance
Acts as a resource - Provides expert internal consultation and facilitation to partners regarding credentialing and privileging matters related to assigned specialties.
Facilitates completion of Focused Professional Practice Evaluation (FPPE) for practitioners in assigned specialties whenever new privileges are granted. Ensures that the results of these evaluations are considered by division chiefs and department chairs as they confirm clinical competence. Collaborates with the Patient Safety and Peer Review Department when the medical staff organization determines that focused review of an individual's clinical practice is required due to potentially adverse information.
Identifies and works to implement best practices. Makes recommendations to policy/procedure
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