Medical Staff Spec

Credentialing And Privileging Manager

Manages advanced credentialing and privileging processes, ensuring compliance with regulatory standards. Serves as subject matter expert and liaison between medical staff, administration, and regulatory bodies.

Audits and evaluates processes involved in verifications for medical staff, allied health practitioners, and advanced practice professionals' appointments, reappointments and privileges delineations.

Coordinates the processing of applications through the hospital review process and committee meeting structure and assures all applications are processed completely and in a timely manner.

Maintains a working knowledge of the medical staff bylaws, medical staff rules and regulations, advance practice professional policies, as well as other policies and procedures pertaining to credentialing, etc.

Works with manager and/or director for assuring that the findings, conclusions and recommendations for actions to appointment or reappointment applications and/or improve the credentialing program are reported through appropriate medical staff committees, or appropriate leadership, and that approved actions are then assigned and/or implemented in a timely manner.

Responsible for contacting Credentials Committee Members regarding monthly review of credentials files and serve as resource to the reviewers for any questions that may arise.

Oversees ongoing development and revisions of delineation of privileges utilizing heavy physician input and physician committee approval.

Participates in system integration and continuing quality improvement efforts.

Assures appropriate implementation of new credentialing software and ongoing development efforts as I related to regulatory agency requirements for credentialing.

Prepare and present credentialing files to medical staff committees.

Lead audits and readiness for accreditation surveys.

Train and mentor junior staff.

Collaborate with legal, quality, and risk departments on provider issues.

Our competitive benefits package includes the following - Immediate eligibility for health and welfare benefits - 401(k) savings plan with dollar-for-dollar match up to 5% - Tuition Reimbursement - PTO accrual beginning Day 1

Note:

Benefits may vary based upon position type and/or level

Qualifications:

Education:

H.S. Diploma/GED Equivalent

Experience:

3 Years of Experience

Certification/License/Registration:
Must obtain one of the following within 24 months of hire:

• Certified Medical Staff Coord (CMSC)
• Certified Provider Credentling Spec (CPCS)
• Certified Prof Medical Services Manager (CPMSM)