Credentialing Operations Leader

The Ohio State University Wexner Medical Center; Columbus (OH); On-site; USD 90,000 - 120,000; Full time

Job summary

The Ohio State University Wexner Medical Center is seeking a Delegated Credentialing Consultant to lead and oversee credentialing operations for OSU hospital corporate services. You will supervise processes for non-physician credentialing, FPPE/OPPE, and delegated credentialing with contracting and MCO liaison activities under the direction of senior leadership.

This role requires managing credentialing databases, audits, and verification of licenses, board certifications, and regulatory

Qualifications

• Bachelor's level degree or equivalent required.
• Strong supervisory, management, communication and writing skills.
• Minimum of five years of hospital experience, preferably in Medical Staff Services.
• Intermediate computer knowledge. Familiarity with medical staff management software desired.

Responsibilities

• Manage non-physician provider credentialing and privileging.
• Oversee non-physician FPPE and OPPE processes.
• Coordinate delegated credentialing functions with MCO and OSUWMC Managed Care Contracting; provide flat files per contracts.
• Manage credentialing database and auditing of files per guidelines.
• Audit credentialing/recredentialing files per standards (TJC, NCQA).
• Enter/audit privileges into credentialing database for CPD interface.
• Oversee verification of licenses, DEA, board certs and other regulatory requirements.
• Manage tracking of GME trainee certificates; liaise with OSMB.
• Manage CAQH database for OSUWMC; track new providers and IDs.
• Manage physician licensure applications; liaison with OSMB, FCVS, FSMB.

Skills

Supervisory

Management

Communication

Writing

Computer literacy

Confidentiality

Education

Bachelor's degree in Medical Staff Sciences

Masters degree preferred

Tools

Medical staff management software

Job description

The Ohio State University Wexner Medical Center is seeking a Delegated Credentialing Consultant to lead and oversee credentialing operations for OSU hospital corporate services. You will supervise processes for non-physician credentialing, FPPE/OPPE, and delegated credentialing with contracting and MCO liaison activities under the direction of senior leadership.

This role requires managing credentialing databases, audits, and verification of licenses, board certifications, and regulatory