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Healthcare Credentialing Coordinator
2 months ago
Position Overview:
The Healthcare Credentialing Coordinator is pivotal in overseeing all functions related to Medical Staff. This role involves leading the credentialing and privileging processes, which includes a thorough analysis of practitioner data to provide informed recommendations to Medical Staff leaders and committees. The coordinator actively participates in quality assessment and improvement initiatives for the Medical Staff, encompassing peer reviews, Focused Professional Practice Evaluations (FPPE), Ongoing Professional Practice Evaluations (OPPE), and necessary corrective actions. Compliance with regulatory requirements, accreditation standards, Medical Staff Bylaws, and organizational policies is paramount.
Key Responsibilities:
- Facilitates and manages the credentialing and privileging processes for medical staff and advanced practice professionals during initial appointments and biennial reappointments. Conducts critical data analysis to support recommendations for credentialing and privileging, ensuring compliance with accreditation standards and relevant laws.
- Maintains up-to-date knowledge of regulatory requirements and accreditation standards, ensuring all practices align with the guidelines set forth by various accrediting bodies. Coordinates survey preparations for regulatory audits and implements necessary actions based on federal and state rulings.
- Develops and enforces Medical Staff bylaws, rules, and regulations, ensuring they govern the activities of the Medical Staff effectively.
- Oversees the onboarding and orientation process for newly appointed practitioners, ensuring they receive the required regulatory and legally mandated education.
- Generates monthly reports for Governing Bodies concerning credentialing, privileging, and other Medical Staff-related matters.
- Collaborates with the quality management department to gather and distribute quality data for FPPE and OPPE processes, ensuring compliance with regulatory requirements.
- Acts as a liaison among medical staff, administration, ancillary departments, and patients to facilitate effective communication.
- Establishes and maintains systems to support committee meetings and communication within the Medical Staff governance structure, adhering to established procedural guidelines.
Qualifications:
- Licensure: None required.
- Education: High School Diploma.
- Experience: Typically requires three years of experience in a healthcare environment, specifically in credentialing and privileging processes.
- Skills: Strong communication, organizational, and problem-solving abilities; proficiency in Microsoft Office Suite; and a solid understanding of medical terminology.
Physical Requirements:
- Ability to sit for extended periods and occasionally lift up to 10 lbs.
- Must possess a valid driver's license and be willing to travel as necessary.
- Work is conducted in a standard office environment.
This job description outlines the general nature and level of work expected from the incumbent. It is not intended to be an exhaustive list of all duties and responsibilities.
