Job Description
Duration: 05 Months contract with possible extension upto 18 months
Key Responsibilities: - Oversee ED Call Schedule and manage committee meetings, including minutes, agendas, and scheduling.
- Screen and pre-vet applicants, ensuring all credentialing data is accurate and complete.
- Enter and maintain provider data in credentialing systems (Cactus, ECHO).
- Audit completed credentialing applications and route files for departmental approval.
- Prepare credentialing files for committee review/approval and ensure compliance with bylaws and accreditation standards (TJC, NCQA, CMS, state/federal regulations).
- Assist with OPPE/FPPE competency data and track expiring licenses/certifications.
Required Qualifications: - Minimum 3 years of experience in credentialing, compliance, audit, or healthcare administration.
- Bachelor's degree in a related field or equivalent experience/training.
- Proficiency in Cactus and ECHO credentialing systems, Microsoft Office Suite, and data management.
- Strong analytical, multitasking, and problem-solving skills with the ability to work under deadlines.
- Ability to collaborate across departments and effectively communicate with stakeholders.
Certification Requirement: - Must obtain Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within 18 months of hire.
Preferred Qualifications: - Experience in a community hospital setting.
- Expert knowledge of accreditation and regulatory requirements (TJC, NCQA, CMS, etc.).
Background/experience in the following duties and responsibilities include: - ED Call Schedule, Committee meeting management including minutes, agenda and scheduling, screening applicants and pre-vetting, data entry into credentialing systems, experience with Cactus and ECHO systems, auditing completed credentialing applications, routing credentialing files for departmental approval, helps prepare files for committee review/approval, monitors file compliance under the bylaws, state/federal regulatory and accreditation agencies, assisting with OPPE/FPPE competency data, and monitoring expirable.
Job Function Summary: - Involves the development, implementation and monitoring of effective and efficient systems to facilitate all aspects of medical staff services and credentialing.
- Provides for the processing of applications and verification of physician licensing and certifications.
- May also involve the preparation of agendas and related materials for medical staff meetings and peer review activities.
- May serve as the liaison between the medical staff and all hospital departments to coordinate and provide overall continuity of medical staff activities.
- Monitors compliance with medical staff bylaws, rules, regulations, policies and procedures.
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