Medical Staff Credentialing Manager manages staff that process credentialing and recredentialing applications for health care providers. Oversees department operations to ensure compliance with all regulatory standards. Being a Medical Staff Credentialing Manager implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Analyzes reports on applications and credentialing status to identify trends and improve the credentialing process. Additionally, Medical Staff Credentialing Manager prepares files for the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a director. The Medical Staff Credentialing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Medical Staff Credentialing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
Full-time 80 hours every 2 weeks | Mon-Fri 8a-5p | Hybrid of in-office (St. Cloud Hospital) and at-home work
JOB SUMMARY:
Responsible for preparing files for medical staff credentialing and privileging for CentraCare within the Clinical Partner Resource Office. The Credentialing Specialist plays a significant key role in assuring physicians and advanced practice providers are qualified to provide quality patient care within CentraCare. The position must accurately and efficiently completes medical staff credentialing, privileging and recredentialing processes in compliance with regulatory requirements, often under short timelines and shifting organizational priorities. In collaboration with physician and advanced practice provider reviewers, incumbent will follow-up on red flag issues in files. Presents files at system-wide Credentialing Committee for discussion and review. Must be highly detail oriented to complete accurate data entry of demographics, education, training, prior hospital affiliations and employment verifications into the credentialing database. Communicate with the practitioners and hospital staff by phone, fax, or email to facilitate the completion or clarification of credentialing and privileging documents. Engages in activities to develop and improve documents, policies and procedures to support day-to-day operations. This role ensures compliance with the Joint Commission, NCQA, Centers for Medicare/Medicaid Services, and other laws or Hospital policies.
Partners with the Manager of Credentialing, Recruitment, Contracting, Department and Medical Staff Leadership, St. Cloud Hospital Vice President of Medical Affairs, Credentials Committee members, members of the Medical Staff, Advanced Practice Providers, and the Medical Staff Office. Supports and implements patient safety and other safety practices as appropriate. Supports and demonstrates Family Centered Care principles when interacting with patients and their families and with co-workers.
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CentraCare has made a commitment to diversity in its workforce. All individuals including, but not limited to, individuals with disabilities, are encouraged to apply. CentraCare is an EEO/AA employer.
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