Credentialing Consultant

Ohio State University; Columbus (OH); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off

State retirement plan

Job summary

Ohio State University in Columbus, OH is seeking a Credentialing Consultant to lead the corporate credentialing services for our university hospitals, under supervision of the Associate Director. This role oversees non-physician credentialing, FPPE/OPPE, and delegated credentialing functions, including contract liaison and data integrity.

You will manage credentialing databases, auditing, licensure verification, and compliance with TJC/NCQA standards, while handling confidential information with

Qualifications

• Bachelor's Level Degree or equivalent combination of education and experience.
• Bachelor degree in Medical Staff Sciences or equivalent courses, training and experience required.
• Strong supervisory, management, communication and writing skills.
• Minimum of five years of experience in hospital setting, preferably in the Medical Staff Services office.
• Intermediate computer knowledge.
• Familiarity with medical staff management software desired.
• Must be able to handle highly confidential information.
• Strong interpersonal and motivational skills.
• Certification as a Provider Credentialing Specialist preferred (CPCS) or Medical Staff Coordinator (CMSC).
• Masters degree preferred.

Responsibilities

• Management of non-physician provider credentialing and privileging
• Management of non-physician FPPE and OPPE processes
• Management of delegated credentialing functions to include contracting, ongoing communication/liaison with MCO and OSUWMC Managed Care Contracting; provision of flat files in accordance with MCO contracts
• Credentialing database management
• Management of auditing of credentialing/recredentialing files in accordance with established guidelines, TJC standards, and NCQA requirements
• Management of data entry/auditing of privileges into credentialing database for interface to CPD
• Management of ongoing verification of licenses, DEA, board certifications, other licensing/regulatory requirements as mandated by law, regulation, accreditation standard, policy, or established standard
• Management of tracking/auditing of graduate medical education trainee certificates; liaison with OSMB
• Management of CAQH database on behalf of OSUWMC and tracking of new providers and assignment of OSUWMC Identification
• Management of physician licensure application process; liaison with OSMB, FCVS, and FSMB

Skills

Leadership

Communication

Writing

Interpersonal skills

Confidentiality

Supervisory skills

Management

Computer literacy

Adaptability

Education

Bachelor's degree

Medical Staff Sciences degree

Master's degree preferred

Tools

Medical staff management software

Credentialing databases

Job description

Job Title

Credentialing Consultant

Department

University Hospital | Credentialing Services

Position Summary

The Delegated Credentialing Consultant leads, directs, monitors, and provides oversight and leadership to ensure operating efficiencies of the corporate credentialing services of the OSU hospitals, under the supervision of the Associate Director of Corporate Credentialing and/or Administrative Director. This position is responsible for management of operational activities related to the various functions that are required of the Corporate Credentialing Office and the CVO (Credentials Verification Organization) and for delegated credentialing requirements. This position is responsible for one or more of the specialty areas below:

Responsibilities

• Management of non-physician provider credentialing and privileging
• Management of non-physician FPPE and OPPE processes
• Management of delegated credentialing functions to include contracting, ongoing communication/liaison with MCO and OSUWMC Managed Care Contracting; provision of flat files in accordance with MCO contracts
• Credentialing database management
• Management of auditing of credentialing/recredentialing files in accordance with established guidelines, TJC standards, and NCQA requirements
• Management of data entry/auditing of privileges into credentialing database for interface to CPD
• Management of ongoing verification of licenses, DEA, board certifications, other licensing/regulatory requirements as mandated by law, regulation, accreditation standard, policy, or established standard
• Management of tracking/auditing of graduate medical education trainee certificates; liaison with OSMB
• Management of CAQH database on behalf of OSUWMC and tracking of new providers and assignment of OSUWMC Identification
• Management of physician licensure application process; liaison with OSMB, FCVS, and FSMB

Qualifications

• Bachelor's Level Degree or equivalent combination of education and experience.
• Bachelor degree in Medical Staff Sciences or equivalent courses, training and experience required.
• Strong supervisory, management, communication and writing skills.
• Minimum of five years of experience in hospital setting, preferably in the Medical Staff Services office.
• Intermediate computer knowledge.
• Familiarity with medical staff management software desired.
• Must be able to handle highly confidential information.
• Strong interpersonal and motivational skills.
• Certification as a Provider Credentialing Specialist preferred (CPCS) or Medical Staff Coordinator (CMSC).
• Masters degree preferred.

Additional Education Desired

Master's Degree or equivalent combination of education and experience

Functional Information

FUNCTION: Health Care Administration

SUB FUNCTION: Delegated Credentialing

CAREER BAND: Individual Contributor - Specialized

CAREER LEVEL: 4

Additional Information

Location: Ackerman Rd, 700 (0921)

Position Type: Regular

Scheduled Hours: 40

Shift: First Shift

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

Equal Opportunity Statement

The university is an equal opportunity employer, including veterans and disability.

Benefits

Ohio State benefits give you options to take care of what matters most to you — and opportunities to make adjustments as your life and needs change, including:

• Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost.
• Paid time off, including sick and vacation time and 11 holidays.
• State retirement plan or an alternative retirement plan, both with generous employer contributions.

About Ohio State University

At Ohio State, you’ll find work that inspires you. We offer roles and growth opportunities in countless fields and specialties — including a job that’s right for you. As Buckeyes, we accomplish more together. No matter your role, you’ll be part of creating what people need now: pathways to education, research and health care. Working at Ohio State means you’re part of a team with a strong sense of community and an unwavering commitment to excellence — and, of course, incomparable Buckeye spirit. We bring out the best in people, help each other succeed and learn together. By joining Ohio State, you become part of a top-20 public university with one of America’s leading academic health centers. We’re a team of dedicated colleagues with access to boundless resources that support you.