GENERAL SUMMARY: Under direction of Medical Staff Services Director, works independently to coordinate a variety of medical staff office functions; has considerable autonomy to set priorities and deadlines within a defined structure, coordinates with and confers with other personnel involved in the credentialing process and is responsible for communicating all activities to the Director of the department.
INTERPERSONAL RELATIONSHIP:
Engages in extensive contact with all levels of personnel and providers inside and outside of the Hospital in a professional and confidential manner.
REPORTING RELATIONSHIPS AND LEVEL OF AUTONOMY:
Reports to and is directly accountable to Department Director. Functions independently with intermittent supervision.
KNOWLEDGE, PRINCIPAL DUTIES AND RESPONSIBILITIES:
1.In collaboration with the Director of the department, prepares, in a timely manner, all applications for reappointment for review by the appropriate department chief, division director and specified committees. As needed, assists in the processing of new applications which includes but is not limited to the maintenance of all files relative to paper and computerized information in accordance with office procedure, regulatory requirements, Medical Staff Bylaws and all related policies, the Joint Commission credentialing standards and appropriate licensing board requirements.
2.Obtains all necessary information and obtains verification of that information as required, to include, but not be limited to: licensure, training, experience, National Practitioner Data Bank, designated references, professional liability insurance and malpractice history and coverage, controlled substances registrations(s), specialty board certification/recertification, other healthcare affiliations, Medicare/Medicaid sanctions, all internal sources such as Quality Management, Clinical Information Services, Pharmacy, Infection Control., etc.
3.Assists with the entire credentialing process, meeting deadlines on the completion of a physician�s application to the medical staff, securing of temporary or emergency privileges for physicians as necessary in compliance with Medical Staff Bylaws and all related policies, the Joint Commission credentialing standards and appropriate licensing board requirements
4.Displays knowledge of when to refer problem applications or situations to the Director of the department.
5.After appointment/reappointment decision is reached, updates existing files to reflect new status and approval at Credentials/MEC/Board of Trustee meetings. In accordance with office procedure, updates electronic database and prepares appointment/reappointment/resignation correspondence.
6.Assists Director in adhering to the FPPE/OPPE policies and procedures.
7.Maintains current reference/resources of all required information. Is knowledgeable as to where to access information if not readily available.
8.Maintains current knowledge of the Joint Commission, Medical Staff Standards, state and federal requirements, hospital and Medical Staff Bylaws, Rules and Regulations, Policies and Procedures. Participates as needed in the Joint Commission preparedness.
9.Ensures that all expiries are obtained and reviewed on a monthly basis, updating the system to reflect changes, verifying as required.
10.Maintains current knowledge of credentialing software used by the department.
11.Provide office coverage as necessary to ensure appropriate level of departmental operation
12.Makes recommendations for change in departmental procedures or computer systems to accomplish goals as necessary.
13.Participates in problem solving by taking the initiative in identifying problems and seek necessary resources or information to assist in solving any problems that arise in the credentialing process
14.Provides customer services as needed
15.Communicates appropriately for every interaction with every person, every encounter, every day.
OTHER DUTIES:
1.Responds to requests for affiliation verification
2.Updating and distributing of the medical staff roster
3.Producing reports as requested
4.Ordering of office supplies
5.Coordinating storage and retrieval of credentials files at Iron Mountain
6.Updating of the National Practitioner Database
Qualifications:
EDUCATIONAL REQUIREMENTS:
High School degree or equivalent required. Associates degree in Medical Staff or Health Science preferred. Able to read, write and speak English.
EXPERIENCE REQUIRED:
Three years of experience in a healthcare administrative position in Medical Staff Credentialing required. Experience with FPPE/OPPE. Computer experience with Microsoft Office, data entry and retrieval required. Familiarity with MIDAS, ECHO, EXCEL, KRONOS and Premier preferred.
PROFESSIONAL LICENSURE/CERTIFICATION:
Current certification by the National Association of Medical Staff Services as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPSC) preferred
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Job: Non-Clinical/Administrative
Primary Location: Worcester, Massachusetts
Facility: Saint Vincent Hospital
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicant�s or employee�s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005038132
About Saint Vincent Hospital
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.
