Imagine being the vital link that connects our talented medical professionals with the heartbeat of the hospital. You’ll be the champion of compliance, ensuring we not only meet but exceed Joint Commission standards. If you’re a detail-oriented problem-solver who loves to support a dynamic team, this could be your next adventure.

QUALIFICATIONS

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• Bachelor’s Degree or equivalent knowledge of medical terminology, and a minimum of three years of experience in a healthcare-related profession.

• Certified Provider Credentialing Specialist (CPCS) through National Association of Medical Staff Services (NAMSS) certification preferred or within one year of eligibility
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• Working knowledge of Joint Commission and National Practitioner Data Bank standards, Conditions of Participation, and other regulations as required.

KNOWLEDGE, SKILLS, AND ABILITIES

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• Demonstrates sound judgement and patience, and always maintains a professional demeanor

• Self-directed, with the ability to handle multiple deadlines and to work in a busy, stressful environment
• Strong organizational skills and the ability to prioritize overlapping and/or conflicting requests
• Ability to use tact and discretion, and maintain confidentiality
• Strong interpersonal verbal and written communication skills, ability to collaborate with providers
• High degree of creativity, problem analysis, and sound decision-making, comfortable with conflict resolution
• Ability to work varied shifts.
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• Administers all aspects of the credentialing and privileging process for medical staff, allied health staff, and medical residents.

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• Gathers, verifies, and analyzes practitioner credentials, ensuring accuracy and completeness.

• Maintains and updates the credentialing database system.
• Processes applications for initial appointments, reappointment, and temporary privileges.
• Manages the focused practitioner performance evaluation (FPPE) and ongoing professional practice evaluation (OPPE) processes.
• Conducts thorough audits of credentialing files to ensure compliance.
• Responds to credentialing verification requests from other healthcare organizations.
• Participate in the development and maintenance of credentialing policies and procedures.
• Ensures compliance with all applicable federal, state, and accrediting body standards (e.g., TJC, NCQA).
• Manages the process for the advancement of practitioners to nonprovisional status.
• Prepares credentialing reports for medical staff committees and leadership.
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• Serves as an essential link between senior hospital administration and the medical staff to promote and enhance communication and positive working relationships, including providing support for and attendance medical staff committees.

• Develops and maintains effective communication with medical staff through minutes, meetings, committee assignments, leadership training and education, physician and resident orientation and onboarding, physician referral directory (?), office and committee handbooks, and special functions such as quality reports, physician education, call schedules, and annual holiday reception.
• Studies, interprets, ensures compliance with, maintains knowledge of, distributes information on, and provides education on Joint Commission standards and other applicable regulations to ensure that all requirements are met for the hospital’s credentialing and privileging process.
• Assist in the development and implement strategies to improve physician access and patient flow within the hospital system, and outreach clinics.
• Collaborate with medical staff, and all levels of the organization on the development and implementation of clinical pathways and protocols to ensure evidence-based and cost-effective patient care.
• Address physician concerns and grievances in a timely and effective manner to maintain positive relationships and foster a collaborative work environment. .
• Maintain current knowledge of organizational policies and procedures, federal, licensing, and state policies and directives.
• Coordinating the peer review process, including scheduling meetings, preparing documentation, and ensuring confidentiality.
• Maintaining records of peer review activities and outcomes.
• Assisting with the development and tracking of physician performance improvement plans arising from peer review.
• Assisting with the onboarding process for new medical staff members beyond initial credentialing (e.g., introductions to key departments, facility tours).
• Assumes any other responsibilities that may be assigned by the CAO on an as needed basis.
• Behave and dress in a professional and courteous manner consistent with the facilities Standards of Behavior.

Please refer the Job description for details