Employment Type:Full timeShift:

Description:ESSENTIAL FUNCTIONS AND RESPONSIBILITIESAssists with the development and ongoing maintenance of the Credentialing department policies and procedure manual.Develops reports and metrics to assist with ongoing monitoring of credentialing activities and productivity standards.Primary point of contact and responsibility for all delegated credentialing activities including audits, post-committee updates, invoicing, and other associated duties.Provides back up support to Credentialing Department leadership for all accreditation surveys.Supports new medical staff member orientation, coordinating with the Regional Health Ministries on development of a standard orientation process and manual.Coordinates the credentialing/recredentialing process, including initializing the process, monitoring, follow-up on required documents, regular reporting of status of initial credentialing/reappointment to Department Chairs and Credentials Committee.  Screens application requests in advance of application launch to identify any potential controversial issues or concerns.Completes final review of recredentialing applications prior to Committee presentation to ensure complete and accurate files. Supports Credentials Committee, Medical Executive Committee, and/or Local Board meetings, which may include coordinating presentations, agenda development, preparation of meeting materials, taking meeting minutes, and follow up on committee initiatives.Maintains and updates confidential physician files.Maintains MSOW database and ensures mailing addresses, telephone numbers, participation in various managed care organizations, and other key demographics are up to date and accurate.Responds appropriately to time-sensitive requests (e.g. critical staffing privileges, visitor and observer privileges).Monitors compliance with applicable rules, regulations, standards, state, and federal law.Offers assistance and support to Credentialing Department leadership.Fields telephone calls and monitors shared email inbox regarding managed care products, application requests, credentialing/recredentialing procedures, etc.Maintains primary contact between the clinical Departments and the Committees.Participates in professional development programs and professional organization to grow in understanding of various regulations and legislation of health care industry as appropriate.

REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE

Education

Associate’s Degree (health care office or business administration or related field) OR equivalent combination of education and experience.  Bachelor’s Degree preferred.

Experience

Minimum of three (3) years of administrative experience, preferably credentialing experience, in a hospital setting or medical staff office.  Experience working with a corporate or contracted credentials verification office (CVO) preferred.

Certification/Licensure

Certified Professional Credentialing Specialist (CPCS) certification preferred.

REQUIRED SKILLS AND ABILITIES

Proficient in the use of credentialing software systems with specific skills in using MSOW processes and the MSOW Administrative Review Module (ARM) preferred. Fundamental knowledge of the Centers for Medicare and Medicaid (CMS), The Joint Commission (TJC), and National Commission for Quality Assurance (NCQA) rules and regulations that govern credentialing and privileging. Ability to work independently with minimal supervision. Strong communication skills including the ability to correspond effectively, as well as verbally convey information clearly, listen actively, and consider varying viewpoints when making decisions. General understanding of the current health care environment, including familiarity with managed care concepts and integrated delivery systems. Strong organizational skills and the ability to provide attention to detail and complete work in a thorough manner.

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.