Medical Staff Credentialing Manager jobs in Colorado Springs, CO

Job Duties Include: 

1. Medical Staff Credentialing and Privileging:

A.  Initial Applications

• Assists new applicants, locum tenens, and advanced practice professionals with the application process.
• Prompts the applicant for additional or missing information as required.
• Records credentialing information for providers/practitioners in a timely fashion.
• Ensures primary source verification is completed on all applications, and verifies that the information provided is valid.
• Creates and maintains the national practitioner database utilizing continuous queries.
• Reviews applications for completeness and flags any adverse trends and patterns; and prepares physician profile prior to Director/Chief of Service presentation.
• Meets with the appropriate Director/Chief of Service to review application documents prior to committee presentation.
• Notifies the applicant, Marketing, hospital departments, and VP’s of any credentialing changes and/or final credentialing decisions of the Board.
• Promptly notifies the Manager, Medical Staff Services of any adverse findings during the application process.
• Processes requests for additional and temporary clinical privileges.

2. Reappointments:

• Prompts medical staff members for submission of the reappointment application and information (providing ample time for response prior to the date that his/her privileges are due to expire).
• Ensures that no member of the Medical Staff or Advanced Practice Professional has an appointment that exceeds 24 months.
• Prompts the applicant for additional or missing information as required.
• Records reappointment information for providers/practitioners in a timely fashion.
• Ensures primary source verification is completed on all applications, and verifies that the information provided is valid.
• Reviews applications for completeness and flags any adverse trends and patterns; and prepares physician profile prior to Director/Chief of Service presentation.
• Meets with the appropriate Director/Chief of Service to review application documents prior to committee presentation.
• Promptly notifies the Manager, Medical Staff Services of incomplete applications.

 3. Credential/Quality Files:

• Ensures that credential and quality files that are kept in a secure area.
• Maintains accurate credential files ensuring license, insurance, DEA, and mandatory certifications are current and OIG/EPLS, NPDB searches are verified timely.
• Maintains accurate quality files ensuring all filing is complete after appointment, reappointment, and/or receipt of other information
• Responds to requests from other hospitals and healthcare organizations for verification of medical staff membership and clinical privileges for current and prior members of the Medical Staff or Advanced Practice Professional Staff.

 4. Medical Staff Committees:

• Attends Medical Staff meetings as assigned
• Prepares minutes, agendas, packets, and any other applicable materials according to the requirements of that committee.
• Provides agenda and copy of meeting materials to appropriate individual/s for review prior to meeting
• Obtains approval of transcribed minutes.
• Organizes and maintains original minutes in a confidential manner in the Medical Staff Office
• Emails meeting notices and reminders

 5. Miscellaneous Duties

• Becomes familiar and complies with all federal and state rules and regulations.
• Ensures Focused Professional Practice Evaluations are completed timely
• Assists with Ongoing Professional Practice Evaluations as necessary
• Assists in CMS and TJC survey preparation
• Actively participates in the HRRMC Organizational Strategic Plan.
• Provides backup coverage for Manager, Medical Staff Services, if necessary.
• May be requested to perform other duties as assigned and qualified.