Credentialing Administrator I

Coordinates departmental activities to ensure quality in conducting, maintaining, and communicating practitioner credentialing, privileging, and primary source verifications. Serves as a resource to and collaborates with management and others to advance the quality of practitioners and patient safety of the facility.

Responsibilities

Coordinates departmental activities to ensure quality in conducting, maintaining, and communicating practitioner credentialing, privileging, and primary source verifications; Serves as a resource to and collaborates with management and others to advance quality of practitioners and patient safety; Coordinates activities for ensuring compliance with accreditation standards and regulatory requirements; Assists with clinical privileging program and development/maintenance of delineations of privileges; Manages data, reporting, and process improvement functions; Prepares applicant credentials files for CPRC, committee, and board approval; Recruits and supervises qualified staff; Serves as liaison and leadership support

Requirements

Associate's degree in business or healthcare related field and 3 years of experience in Medical Staff credentialing and/or payer enrollment functions required; Or equivalent combination of education and experience; Fluent English language skills (oral and written) required; Proficiency in MS Office (e.g. Word, Excel, and PowerPoint), email, and internet required

Nice to have

Knowledge of and experience with Joint Commission, CMS, and NCQA Regulations related to medical staff services and Commercial Payers Credentialing preferred; Exceptional interpersonal and communication skills preferred; Ability to develop and maintain relationships with a variety of key stakeholders across the organization preferred; Knowledge of and experience with database applications preferred; Experience with criteria based clinical privileging process preferred; Demonstrated strong familiarity with clinical environments preferred; Certified Medical Professional Services Management (CPMSM) upon hire preferred; Certified Provider Credentialing Specialist (CPCS) upon hire preferred