Credentialing Specialist

Credentialing Specialist

Cayuga Health and its affiliates are the region's leading healthcare system and most trusted providers of integrated health services, empowering our people in our mission to equitably improve the well-being of the communities we serve. Our commitment to providing extraordinary healthcare begins with our team of extraordinary professionals who are continuously discovering clinical innovations and enhancing access to the most up-to-date facilities, equipment, technologies, and research protocols. Cayuga Health's commitment to our employees includes competitive compensation, comprehensive employee benefits programs, and the opportunity to explore and build a career in healthcare through our many professional development programs. 

Coordinates and directs medical staff activities in consultation with Vice President of Medical Affairs, Medical Center President/CEO. Applies general understanding and specific procedures and policies through independent judgment. Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies. Supports departmental activities to ensure quality in conducting, maintaining, and communicating physician credentialing, privileging, and source verifications. Serves as a resource to, and collaborates with, others to advance the quality of practitioners and patient safety of the facility.

Roles And Responsibilities

• Review resumes and applications to ensure candidates meet licensing, credentialing, and eligibility requirements, including primary source verification and compliance with state and federal regulations.
• Analyze application materials for completeness, inform practitioners of status, and gather additional information as needed to finalize credentialing.
• Conduct background checks, verify training and certifications, perform clinical competency evaluations, and facilitate peer reviews.
• Maintain up-to-date databases for medical professionals and healthcare facilities, including initial credentialing, reappointments, and modifications.
• Compile and evaluate practitioner-specific data for decision-making bodies, ensuring compliance with accreditation standards and regulatory requirements.
• Facilitate medical staff functions such as orientation, training, and maintaining current credentialing files while organizing data to identify trends and underlying issues.
• Adapt to other responsibilities as needed to support the credentialing and compliance processes effectively.
  
  

Required Skills And Experience

• Education - Associate's degree or H.S. Diploma with minimum of 5 years directly related experience and CPSC Certification.
• In lieu of the above education requirement previous work history and years of experience and certification may/will be considered.
• Residency in New York State
• Five years of Medical Staff Office and Credentialing experience.
• Strong oral and written communication skills.
• Working knowledge of software applications including Microsoft Word, Excel, and PowerPoint.
• Ability to handle sensitive information with absolute confidentiality.
• Organizes work, effectively prioritizes, and sets short- or long-term goals and strategies to achieve them.
• Aligns communication, people, processes, and resources to drive success.
• Understands clinical competence evaluation concepts, key functions and terminology,
  
  

Preferred Skills And Experience

• CPCS certification preferred
• Residency in New York State and familiarity with NYS requirements preferred.
• Knowledge and understanding of Cayuga Health System medical staff, Medical Bylaws, Joint Commission Regulations, NYS Regulations, NCQA and CMS Regulations.
  
  

Physical Requirements

• The ability to lift 25 pounds.
  
  

Location and Travel Requirements:

• Hybrid
• Cayuga Medical Center
  
  

Compensation Disclosure

• $45,163.44 to $55,206.72
  
  

Cayuga Health System and its affiliates are committed to treating all patients, providers, staff and volunteers equitably and with dignity, ensuring the highest levels of safety, care and respect, and striving to recognize and overcome biases and policies that contribute to disparities in healthcare access, equitable care and positive health outcomes for all.

We are proud to be an Equal Employment Opportunity employer, supporting the growth and health of our employees and community by embracing the rich diversity, needs and circumstances of all peoples and prioritizing opportunities to build a diverse and inclusive workplace. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable protected characteristics.

If you require reasonable accommodation to complete a job application, pre-employment testing, a job interview or to otherwise participate in the hiring process, please contact the Cayuga Health Talent Acquisition team at talentacquisition@cayugahealth.org.

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