Job Details

Duration: 06 Months contract with possible extension

Key Responsibilities:

1. Oversee ED Call Schedule and manage committee meetings, including minutes, agendas, and scheduling.
2. Screen and pre-vet applicants, ensuring all credentialing data is accurate and complete.
3. Enter and maintain provider data in credentialing systems (Cactus, ECHO).
4. Audit completed credentialing applications and route files for departmental approval.
5. Prepare credentialing files for committee review/approval and ensure compliance with bylaws and accreditation standards (TJC, NCQA, CMS, state/federal regulations).
6. Assist with OPPE/FPPE competency data and track expiring licenses/certifications.

Required Qualifications:

1. Minimum 3 years of experience in credentialing, compliance, audit, or healthcare administration.
2. Bachelor's degree in a related field or equivalent experience/training.
3. Proficiency in Cactus and ECHO credentialing systems, Microsoft Office Suite, and data management.
4. Strong analytical, multitasking, and problem-solving skills with the ability to work under deadlines.
5. Ability to collaborate across departments and effectively communicate with stakeholders.

Certification Requirement:

1. Must obtain Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within 18 months of hire.

Preferred Qualifications:

1. Experience in a community hospital setting.
2. Expert knowledge of accreditation and regulatory requirements (TJC, NCQA, CMS, etc.).

Job Function Summary:

1. Involves the development, implementation, and monitoring of effective and efficient systems to facilitate all aspects of medical staff services and credentialing.
2. Provides for the processing of applications and verification of physician licensing and certifications.
3. May also involve the preparation of agendas and related materials for medical staff meetings and peer review activities.
4. May serve as the liaison between the medical staff and all hospital departments to coordinate and provide overall continuity of medical staff activities.
5. Monitors compliance with medical staff bylaws, rules, regulations, policies, and procedures.