MEDICAL STAFF & CREDENTIALING COORDINATOR (HYBRID)

A Brief Overview

The Medical Staff Services and Credentialing Coordinator is responsible for oversight of the credentialing process and analyzing and evaluating primary source verification data and documents for initial appointments and reappointments to the Medical Staff and Allied Health Staff. This position provides support for facility and / or specialty assignments throughout the health system. Under the supervision of the Supervisor and Manager of Medical Staff Services and Credentialing and in addition to the duties outlined below, this position functions as an agent of the protected peer review process. This position is responsible to maintain and develop community, UHMP / UHMG / UHRP provider and hospital leadership relationships.

What You Will Do

• Analyzes and processes initial and reappointment applications by utilizing independent critical thinking skills, which may involve extensive investigative review and interpretation
• Collaborates with clinical leaders to review and recommend applicants, highlighting critical details and potential red flags
• Maintains current knowledge of and adheres to hospital and outside accreditation and regulatory standards (Joint Commission, Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), etc.), as a function of the hospital's risk management program for hospital and delegated credentialing and hospital privileges
• Participates in all aspects of meeting management, to provide support for Credentials Committee, Medical Executive Committee / Clinical Council, Quality & Professional Affairs Committee, Hospital Board, and all other applicable medical staff meetings
• Partners with Medical Staff Leaders to develop policies, evaluation standards and privilege forms based on regulatory changes or hospital service changes
• Acts as a liaison with Board Members, UH Senior Leaders and outside agencies (e.g. the Ohio State Medical Board, the National Practitioner Databank, Board Certification agencies, the Drug Enforcement Agency, and malpractice insurance carriers)
• Leads and manages provider performance evaluation process in accordance with Joint Commission Standards and Medical Staff Bylaws
• Investigates issues that arise with providers and may involve physicians, UH staff, and / or hospital leadership
• Assists with updating and creating new operational procedures as needed in conjunction with the Supervisor and Manager
• Serves as content expert and participates in onboarding and training of new team members
• Supports the medical staff with credentialing related projects as assigned
• Utilizes current trends and practices in all aspects of credentialing and privileging
• Manages data quality and integrity for web-based applications based on defined standards through systematic audits.

Additional Responsibilities

Qualifications : Education

Work Experience

Knowledge, Skills, & Abilities

Licenses and Certifications

Physical Demands

Travel Requirements

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