Medical Staff Services Coordinator

Alameda Health Sytem; Oakland (CA); On-site; USD 60,000 - 85,000; Full time

Job summary

Alameda Health Sytem in Oakland is seeking a Credentialing Specialist to coordinate the credentialing and privileging process for affiliated medical staff and advanced practice providers.

You will collect primary source verifications and analyze data to ensure compliance with bylaws, policies, and regulatory requirements.

Qualifications

• High School diploma or equivalent.
• One year of Medical Staff Services, Quality Improvement or Human Resources experience, or two years as Administrative Assistant.
• Preferred experience credentialing/privileging providers in a hospital/acute care setting.
• Certification from the National Association of Medical Staff Services as CPCS or CPMSM preferred.

Responsibilities

• Facilitates credentialing and privileging for physicians and advanced practice providers.
• Performs primary source verifications and gathers additional information for peer review decisions.
• Ensures compliance with Joint Commission, NCQA, state and federal requirements; participates in survey readiness.
• Maintains data entry accuracy and confidentiality.

Skills

Credentialing/Privileging

Administrative support

Education

High School diploma or equivalent

Job description

SUMMARY: Assists in coordination of all aspects of the credentialing and privileging process and reappointment process for affiliated medical staff and advanced practice providers. Responsible for collecting primary source verifications and analyzing and accurately updating data that is collected to ensure compliance with established criteria. Collaboration with Medical Staff Leadership, Administration and Provider Enrollment to ensure compliance with Medical Staff Bylaws, organizational policies, legal and regulatory requirements.

DUTIES & ESSENTIAL JOB FUNCTIONS:

• 1. Facilitates the credentialing and privileging application/reapplication process for physicians and advanced practice providers.
• 2. Conduct primary source verifications, pursuing additional information for effective and comprehensive peer review decision-making.
• 3. Facilitates compliance with, and maintains current knowledge of, the Joint Commission, NCQA, state and federal requirements, hospital and Medical Staff Bylaws, Rules and Regulations, Policies and Procedures. Participates in the survey process and preparedness.
• 4. Manages the focused professional practice evaluation process for routine proctoring.
• 5. Collaborates interdepartmentally with physician leaders, Human Resources, Information Systems and Provider Enrollment departments to coordinate provider onboarding.
• 6. Conducts ongoing monitoring of licensure and federal sanctions.
• 7. Facilitates evaluation of events or actions against a provider in accordance with the reporting obligations defined in the Medical Staff Bylaws.
• 8. Facilitates off-cycle credentialing and privileging actions including, but not limited to, leave of absences, resignations, and status changes.
• 9. Maintains accurate data entry, integrity and confidentiality.
• 10. Performs databased audits/clean up as necessary.
• 11. Provides departmental support, as needed, with all aspects of the medical staff services, credentialing and privileging functions.
• 12. Communicates credentialing and enrollment updates to provider enrollment.
• 13. Perform other related duties as assigned.

MINIMUM QUALIFICATIONS:

• Required Education: High School diploma or equivalent.
• Required Experience: One year of Medical Staff Services, Quality Improvement or Human Resources, or the equivalent of two years’ experience as an Administrative Assistant.
• Preferred Experience: Recent experience credentialing/privileging providers in a hospital/acute care setting.
• Preferred Licenses/Certifications: Certification from the National Association of Medical Staff Services as either a Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM).