JOB SUMMARY 

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Hybrid Position

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Accountable for the computerized operations of the centralized credentials verification system by managing all components of the medical staff database, including data entry, creating reports, and maintaining software.  Serves as team member in coordinating medical staff and allied health professional initial appointments and reappointments.  Tracks the flow of credentialing information throughout the Scott & White System and to delegating credentialing entities.  

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Under general supervision, accountable and accountable for all functions relating to the administrative work in coordinating credentialing and re-credentialing and the clinical privileging of the medical staff and delineation of services for the allied health professionals and others as appropriate for the Baylor Scott & White Health. Accountable for the accuracy and integrity of the credentialing and clinical privileging database system.  Functions as a member of the team to assure optimum performance of the department.

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Provides information and guidance about medical staff bylaws, medical staff rules and regulations, allied health professionals (AHP) policies, Joint Commission for Accreditation of Healthcare Organizations (JCAHO) and Center for Medicare and Medicaid Services (CMS) and other regulatory agencies as they pertain to medical staff and allied health professionals.

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ESSENTIAL FUNCTIONS OF THE ROLE

\n\nProcesses confidential medical staff and allied health professional files requests for, but not limited to new applications, reappointment applications, temporary applications, more privileges, staff category changes, resignations / retirement.\nMaintains data integrity of the credentialing and clinical privileging software system. According to established policies and procedures, accountable for the integrity of data\nObtains primary source information through utilization of verification software/ databases as well as approved verification sites via the Internet.\nEnsures maintenance of medical staff and allied health professional files.\nEnsures that results of medical staff quality management findings are provided to appropriate review committees/ departments and maintained in a confidential file.\nMaintains a working knowledge of the medical staff bylaws, medical staff rules and regulations, allied health professional policies, as well as other policies and procedures pertaining to credentialing, etc.\nActs as a liaison between the medical staff, allied health professionals, nursing services and administration.\nPerforms other duties as required. Job duties are subject to changes as directed by management.\nAccountable for recording and maintaining clinical privileges for physicians and allied health staff members in the database.\nCoordinates the credentialing, re-credentialing and clinical privileging process of new applications and reappointment applications to the medical staff and allied health professionals in compliance with the medical staff bylaws, medical staff policies and procedures, AHP policies, JCAHO, CMS standards and other regulatory agencies.\nOversee the system credentialing database\nDevelops a standardized system of database entry/attributes and trains staff on standardized data entry to the system.\nUtilizes software functions to convert paper documents to electronic files where possible.\nWorks with IS on web-based links to help on-line privilege queries and directories.\nExecutes initial appointment and re-appointment application under departmental policy\nReceives applications and enters data and requested privileges into the credentialing database.  Prepares application packets for distribution to applicants.\nAssigns applicants to appropriate facility(s) and communicate with appropriate facility representatives.\nScans and emails completed credentials files to appropriate facility(s) in a timely way.\nMaintains records of all changes to practitioner status and demographics and communicates to appropriate departments.\nPlans and develops helping documentation (agendas, minutes, reports for Credentials Committee and others as assigned.\nMonitors time-limited documents to assure continuous currency\nFollows departmental expiring document policy to assure proper notification to practitioners of impending expirations.\nAccesses primary verification sources to document renewed licenses and certifications, enters renewals into database and files hard copy in credentials file.\nNotifies director of expiring documents.\nDesign reports and queries to help the functions of the department\nPrepares scheduled and ad hoc reports for both internal and external customers according to established timelines and distribution lists.\nMaintains current knowledge of the joint commission and NCQA Standards\nRegularly participates in learning opportunities to keep current in the credentialing industry.\nPreferred: Medical Staff Services certification: Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) or education plan to obtain in eighteen (18) months from date of hire.\nPerform other position duties as required\n\n

KEY SUCCESS FACTORS

\n\nCommitment to continuous learning and keeping abreast in the Medical Staff Services industry.\nExperience in database management, medical staff and/or credentialing services required.\nExceptional organizational skills, independent work management skills, and proficiency in working with computerized databases required.\nBachelor's degree preferred.\nCPCS certification by the National Association of Medical Staff Services preferred.\nCactus experience preferred.\n\n

BENEFITS

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Our competitive benefits package includes the following

\n\nImmediate eligibility for health and welfare benefits\n401(k) savings plan with dollar-for-dollar match up to 5%\nTuition Reimbursement\nPTO accrual beginning Day 1\n\n

Note: Benefits may vary based on position type and/or level

QUALIFICATIONS

\n\n\n\tEDUCATION - H.S. Diploma/GED Equivalent\n\tEXPERIENCE - 2 Years of Experience\n