Post Date: 2024-05-01
Job ID: 13973120240501
Job Title: Clerical – Credentialing
Job Location: York, PA, US 17401
Job Type: Temporary $20.00 – $25.00 per hour
Position: Medical Staff Services Coordinator
Job Description:
Provides oversight of physician and advanced practice provider initial/provisional credentialing and reappointment processes and ensures credentialing activities are completed accurately and within appropriate timeframes.
Provides oversight of credentialing by maintaining an accurate, secure, and current database of all physicians and advanced practice providers.
Employs critical thinking and independent judgment to evaluate and determine an applicants eligibility for Medical Staff membership and privileges. Utilizes various internal and external resources and databases to gather and analyze physician and advanced practice providers credentialing and performance data used in the reappointment, peer review, and performance improvement processes of the medical staff.
Leverages systems such as Symplr, RemedyForce, SecZetta, and the Virtual Radiology Portal.
Monitors timely and satisfactory completion of mandatory educational and training elements, including, but not limited to, LMS, case logs, EMTALA, and privilege-specific training requirements.
Recognizes, investigates, and validates discrepancies and adverse information obtained from credentialing applications, primary source verifications, or other sources.
Utilizes critical thinking and discretion to maintain peer review and professional conduct protection, escalate safety and quality concerns, and recognize legal implications of credentialing functions.
Collaborates with medical staff leaders and/or senior administration regarding confidential and time sensitive issues, to guarantee accurate review of provider credentials and qualifications.
Drafts appropriate correspondence utilizing knowledge of state statutes and legal guidelines in requesting additional information from external medical and legal sources.
Manages the collection and compilation of performance data for physician and advanced practice providers quality profiles, including references for low volume providers.
Compiles, evaluates and presents accurate and complete initial/provisional and reappointment applications, as well as all pertinent credentialing and accreditation information to Medical Staff leadership, Credentials Committee, Medical Executive Committee and the Board of Directors for review and appropriate action.
Works collaboratively with survey personnel and Accreditation and Licensure leadership to ensure and maintain compliance with accreditation and regulatory requirements by various regulatory bodies, including, but not limited to, the Department of Health, Centers for Medicare and Medicaid Services, The Joint Commission and/or Det Norske Veritas.
Provides input as a subject matter expert to draft revisions of system and entity governing documents, Medical Staff Rules and Regulations and privileging criteria to ensure and maintain accreditation and regulatory compliance.
Provides support to the medical staff, particularly elected and appointed Medical Staff Officers.
Provides assistance in orienting new medical staff members to entity protocols and services.
Interfaces between multiple departments, committees, administration, medical staff, CVO and Peer Review.
Compiles, evaluates, and presents data for and prepares regularly scheduled and ad hoc reports, analyses, and statements.
Prioritizes and organizes work requests, reacting to urgent time-sensitive needs by activating the department help chain, as appropriate, and follow-up, as needed.
Actively participates within the Organizations Lean Daily Management System.
Adheres to established policies and procedures, objectives, quality assessment and safety standards.
Committed to professional growth and development.
Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
Inspires trust and confidence amongst stakeholders through reliability, authenticity, and accountability.
Expresses thoughts clearly, concisely, and effectively, both verbally and in writing. Ensures fluidity of information sharing and communication across the organization by actively listening and encouraging the open expression of ideas and opinions.
Establishes productive, cooperative relationships with subordinates, peers, management, and stakeholders, both internal and external, to the organization.
Maintains professionalism at all times.
Audits, assesses, procures, implements, effectively utilizes and maintains practitioner/provider credentialing processes and information systems (e.g., files, reports, minutes, databases) by analyzing the needs and resources of medical services/credentialing.
Applies knowledge, expertise, sound judgment and consults references and resources, as necessary, to generate and evaluate solutions and recommendations regarding the credentialing and privileging process.
Systematizes work, sets priorities, and determines short- or long-term goals and strategies Aligns communication, people, processes, and resources to drive success.
Displays knowledge of key functions, terminology, and work products of legal, information technology, risk management, and performance concepts.
Assimilates information and data to identify/explain trends, problems, and their causes. Compares, contrasts, and combines information to determine underlying issues.
Qualifications:
Associates Degree Required
1 year Experience in medical staff services required
Experience in business administration or healthcare required
Medical Terminology
Excellent interpersonal/communication skills and computer skills.
Please reference Job number: 139731
Post Expires: 07/30/24