Medical Staff Services Coordinator

Alameda Health System; Oakland (CA); Vor Ort; USD 65.000 - 80.000; Vollzeit

Zusammenfassung

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.

Qualifikationen

• 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.

Aufgaben

• 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.

Kenntnisse

Credentialing coordination

Primary source verifications

Compliance with Joint Commission/NCQA

Data integrity and confidentiality

Interdepartmental collaboration

Attention to detail

Ausbildung

High School diploma or equivalent

Certification: CPCS/CPMSM preferred

Jobbeschreibung

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:

NOTE: Following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.

• Facilitates the credentialing and privileging application/reapplication process for physicians and advanced practice providers.


• Conduct primary source verifications, pursuing additional information for effective and comprehensive peer review decision-making.


• 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.


• Manages the focused professional practice evaluation process for routine proctoring.


• Collaborates interdepartmentally with physician leaders, Human Resources, Information Systems and Provider Enrollment departments to coordinate provider onboarding.


• Conducts ongoing monitoring of licensure and federal sanctions.


• Facilitates evaluation of events or actions against a provider in accordance with the reporting obligations defined in the Medical Staff Bylaws.


• Facilitates off-cycle credentialing and privileging actions including, but not limited to, leave of absences, resignations, and status changes.


• Maintains accurate data entry, integrity and confidentiality.


• Performs databased audits/clean up as necessary.


• Provides departmental support, as needed, with all aspects of the medical staff services, credentialing and privileging functions.


• Communicates credentialing and enrollment updates to provider enrollment.


• Perform other related duties as assigned.

Minimum Qualifications

Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

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).