JOB SUMMARY
\nHybrid position - Dallas, TX
\nUnder general supervision, 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. Provides information and guidance about medical staff/medical group bylaws/policies, medical staff/medical group rules and regulations, allied health professionals (AHP) policies, Joint Commission for Accreditation of Healthcare Organizations (JCAHO) and Center for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA) and other regulatory agencies as they pertain to medical staff/medical group and allied health professionals. Requires 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.
\n\nESSENTIAL FUNCTIONS OF THE ROLE
\n\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/medical group policies and procedures, AHP policies, JCAHO, CMS, NCQA standards and other regulatory agencies including payer delegation agreements.\nProcesses confidential medical staff/medical group 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/medical group and allied health professional files.\nEnsures that results of medical staff/medical group quality management findings are provided to appropriate review committees/ departments and maintained in a confidential file.\nMaintains a working knowledge of the medical staff/medical group bylaws, medical staff/medical group 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/medical group, allied health professionals, nursing services and administration, practice operations and recruitment.\nPerforms other duties as required. Job duties are subject to changes as directed by management.\nAccountable for recording and maintaining medical group credentialing status, clinical privileges for physicians and allied health staff members in the database.\n\n\nBENEFITS
\nOur 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\nNote: Benefits may vary based on position type and/or level
QUALIFICATIONS
\n\n\n\tEDUCATION - Bachelor's\n\tEXPERIENCE - 10 Years of Experience\n