Medical Staff Credentialing Coordinator

4 weeks ago

Rancho Mirage, United States Eisenhower Health Full time
  • Job Objective: A brief overview of the position.
    • Responsible for credentialing and privileging activities of the medical staff and advanced practice providers (APP). Serves as a primary resource and liaison for the medical staff and advanced practice providers and department chairs, medical staff officers and committee chairs. Responsible for coordination of the Credentials Committee and Interdisciplinary Practice Committee including: agendas, minutes, and follow-up correspondence and activities. Oversees the credentialing processes to assure compliance with all applicable regulatory standards and medical staff requirements. Working knowledge of the Medical Staff Bylaws, The Joint Commission and State and Federal Regulations.
  • Reports to
    • Director,-Medical Staff Services
  • Supervises
    • N/A
  • Ages of Patients
    • N/A
  • Blood Borne Pathogens
    • Minimal/ No Potential
  • Qualifications
    • Education
      • Required : Bachelor Degree
    • Licensure/Certification
      • Required : CPCS or CPMSM National certification. Participate in ongoing education to attain Continuing Education Unites required to maintain national certification.
    • Experience
      • Required: 3 years in a hospital medical staff office performing duties representative of this position
  • Essential Responsibilities
    • Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
    • Coordinates credentialing process for initial appointment and reappointment of physicians and advanced practice providers (APP) and locum tenens. Responsible for ensuring applicant's qualifications meet or exceed established guidelines set by the medical staff and all required information is verified prior to review by Section Chiefs/Department Chairs and submission to Credentials Committee or Interdisciplinary Practice Committee.
    • Evaluate primary source responses and alert applicable leaders as red flags are identified to ensure any additional follow-up is performed timely and there are no surprises that would delay a provider beginning to work.
    • Responsible for ensuring all reappointments are completed according to schedule and do not exceed the two-year reappointment period as specified by the Joint Commission/CMS.
    • Ensures competency requirements set by Departments and/or Specialty sections are adhered to by all practitioners; following up when necessary to gather applicable support documentation.
    • Prepares and processes Temporary Privilege requests when applicable.
    • Serves as primary liaison to Department Chairs and Section Chiefs.
    • Updates practitioner demographic information as applicable to ensure integrity of the medical staff credentialing database and assures quality and accuracy of data.
    • Prepares Credentials and Interdisciplinary Practice meeting minutes, confidential correspondence, and follow-up.
    • Prepares Credentials and Interdisciplinary Practice reports to MEC/BOD.
    • Monitors licensures/certificates, malpractice, sends reminder notices, and updates ECHO database with renewals prior to expiration.
    • Coordinates New Physician Orientation process by notifying practitioners, preparing orientation manuals, facilitating physician lab coats, photo ID with HR, etc.
    • Prepares updates to Reappointment Schedules as specialty cycles are completed.
    • Prepares BOD approval letters based on Credentials report.
    • Participates and contributes to quality improvement activities of the department.
    • Researches new technology and new privileges to the organization to assist with the development of criteria and collaborate with IT to ensure ability to generate activity reports.
    • Leads the ongoing review and updating of criteria for privileging and coordinators the medical staff leadership review and approval of such.
    • Assesses proctoring status at the time of provisional review, ensuring all requirements are met prior to advancements.
    • Ensures reappointments to provisional status do not exceed two years.
    • Generates OPPE reports and ensures they are included in the review of competency at the time of provisional review and reappointment.
    • Orient new physician leaders & guide them on an ongoing basis, to ensure compliance with Joint Commission and CMS requirement.
    • Assist program manager with daily operations including meeting management, minutes, follow-up, submitting recommendations to the medical executive committee in the absence of other department members.
    • Performs other duties as assigned.

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