Medical Staff & Credentialing Coordinator (Hybrid)

Description
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 hospitals 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
Performs other duties as assigned.
Complies with all policies and standards.
For specific duties and responsibilities, refer to documentation provided by the department during orientation.
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
Equal Opportunity Employer — minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity