Medical Staff Credentialing & Privileges Coordinator

Alameda Health System; Oakland (CA); On-site; USD 65,000 - 80,000; Full time

Job summary

Alameda Health System seeks a Credentialing Specialist to coordinate credentialing and privileging for affiliated medical staff and APPs. You will collect primary source verifications, analyze data, and ensure compliance with bylaws, policies, and regulatory requirements.

You will collaborate with Medical Staff Leadership, Administration and Provider Enrollment to support onboarding and ongoing credentialing activities within a hospital/acute care setting.

Qualifications

• Required knowledge of credentialing and privileging processes.
• Experience with primary source verifications and data analysis.
• Familiarity with Medical Staff Bylaws, policies, and regulatory requirements.
• Experience in hospital/acute care setting preferred.

Responsibilities

• Facilitates credentialing and privileging applications for physicians and APPs.
• Conducts primary source verifications and collects information for peer review.
• Ensures compliance with Joint Commission, NCQA, state and federal requirements.
• Monitors focused professional practice evaluation for proctoring.
• Coordinates provider onboarding with physician leaders, HR, IS, and Provider Enrollment.
• Monitors licensure and federal sanctions.
• Evaluates events against reporting obligations in Medical Staff Bylaws.
• Facilitates off-cycle credentialing actions including leaves of absence and resignations.
• Maintains data entry integrity and confidentiality.
• Performs databased audits and cleanup as needed.
• Provides departmental support across credentialing and privileging functions.
• Communicates credentialing updates to provider enrollment and supports related duties.

Skills

Credentialing coordination

Primary source verifications

Compliance with Joint Commission/NCQA

Data integrity and confidentiality

Interdepartmental collaboration

Attention to detail

Education

High School diploma or equivalent

Certification: CPCS/CPMSM preferred

Job description

Alameda Health System seeks a Credentialing Specialist to coordinate credentialing and privileging for affiliated medical staff and APPs. You will collect primary source verifications, analyze data, and ensure compliance with bylaws, policies, and regulatory requirements.

You will collaborate with Medical Staff Leadership, Administration and Provider Enrollment to support onboarding and ongoing credentialing activities within a hospital/acute care setting.