Medical Staff Coordinator (Credentialing) - Pacifica Hospital of the Valley

Reporting to the Director Medical Staff, the MEDICAL STAFF COORDINATOR / CREDENTIALING is responsible for the initial appointment and reappointment process for physician / provider to the medical staff. In addition, this position will support the Director with other Medical Staff duties, including meeting preparation and minutes.

RESPONSIBILITIES:

• Ensures the credentialing of applicants for membership and reappointment is coordinated accurately and timely in compliance with defined schedules. Collects and analyzes information thoroughly to identify potential quality of care issues, behavioral problems, appropriate education, and training. Investigates issues of concern, generates reports, and presents findings to facilitate recommendations to the Medical Executive Committee.
• Maintains MD Staff database recording provider statistics for currently approved appointees to be used for continuous credentialing purposes and management reporting.
• Responds to Hospital Affiliation Requests from other facilities.
• Utilizes the credentialing program (computerized) to obtain verification in a minimum amount of time.
• Activates and monitors the proctoring process to include timely data collection, analysis, and reporting assuring compliance with the rules and regulation.
• Interfaces effectively with the Quality Improvement and Risk Management departments to integrate quality of care and risk management findings into the proctoring and reappointment process resulting in acceptable outcomes.
• Meets with the appropriate medical staff department and committee chairs to facilitate the accurate and timely processing of applications. Manages and supports the ad hoc Credentials Committee.
• Maintains current verification of licensure, DEA malpractice insurance, and certificate information in credentials file.
• Assists with OPPE Reporting
• Assists with maintaining Physician Contract Agreements, monitoring monthly provider contracted payments.
• Assists the Director Medical Staff with the daily operations of the department.

EDUCATION/TRAINING/EXPERIENCE:

• High School diploma or equivalent
• Usual education and experienced needed for satisfactory performance in a medical staff office
• Demonstrated knowledge of healthcare industry preferred
• Above average computer skills, including Microsoft Word and Excel
• Strong problem-solving skills
• Ability to exercise professional judgment in performing day-to-day activities, ensuring adherence to hospital policies and procedures
• Excellent verbal and written communication skills
• Ability to meet multiple deadlines in a stressful environment

PI250573066