Position Summary:

 Promote system‐wide best practice and compliance with State and regulatory standards for credentialing and medical staff functions.

Education, License & Cert: 

Certified Professional Medical Services Management or Certified Provider Credentialing Specialist desired. A Bachelors’ Degree in Business Administration or related field preferred.

Experience: 

5 years prior experience performing duties specifically relevant to credentialing in a healthcare environment is required. Knowledge of credentialing standards and medical staff policies and procedures and Medical Staff Bylaws. Knowledge of Office 365 Suite and Excel required. Candidate must have the ability to multi‐task, work independently, and be self motivated.

Essential Functions: 

1. Oversight responsibility for centralized credentialing functions ‐ direct staff to meet deadlines and organize workload.

2. Analyze applications and supporting documents for completeness and eligibility according to standards and bylaws.  Identify and investigate potential areas of concern for physician leaders and legal counsel.

3. Responsible for RPH Medical staff office functions.

4. Key contact and super user for the ECHO credentialing/provider database software. Process invoices, coordinate training and access.

5. Liaison between medical staff and administration.  Maintains current knowledge of The Joint Commission, AOA and NCQA credentialing standards as well as applicable State/Federal regulations.

6. Coordinate Medical Staff Bylaws amendments and medical staff policy changes.

7. Assist in confidential peer review related activities. Disseminate and compile practitioner data.

8. Maintain confidential physician files, accurate provider information and physician rosters.

9. Hire, train, supervise and evaluate credentialing staff.

10. Conduct audits, complete verification requests and participate in surveys, as necessary.

11. Interacting/work with multiple other departments to meet credentialing/hiring goals of department and organization.

12. Contact with multiple organizations, by phone, email, and letter.

13. Ability to document, track and follow‐up on all efforts to obtain verification of candidate credentials.

14. Contact/interface and reporting/interaction with senior leadership. 15. Ability to work on urgent or emergent basis on request.

Other Duties:

 1.  It is understood that this description is not intended to be all‐inclusive and that other duties may be assigned as necessary in the performance of this position.

Pay range min $28.27/hr max $44.13/hr