Please see below for Career Opportunities at the following organizations:

Tuality Community Hospital, Hillsboro, Oregon  |  Kaiser Permanente, Portland, Oregon   |   Legacy Health, Portland, Oregon   |   Regence Credentialing, Portland, Oregon  

Peace Health Southwest Medical Center, Vancouver, WA

Tuality Community Hospital | Hillsboro, OR

Certified Medical Staff Coordinator

Job Description

CPCS required

·         Part-time, 48 hours, day shift

·         Education – Bachelor’s degree or associate degree in Medical Staff Management Services preferred

·         Types 70 wpm and possesses transcription skills and medical terminology knowledge, as well as accurate spelling and grammar skills

·         Demonstrate experience and knowledge of TJC, NCQA and CMS, medical staff, governing board and other regulatory agency standards

·         Coordinates the activities of the Medical Staff.  Provides support services to the Medical Staff Officers.  Disseminates committee referrals to ensure communication between committees

·         Coordinates credentialing for Tuality Healthcare (THC) and Tuality Health Alliance (THA).

·         Maintains permanent file of original minutes.

·         Oversees maintenance of hard files and software database on all Medical Staff members to assure database is current.

·         Coordinates credentialing process to assure appointment and reappointment on a timely basis, as well as temporary privileges.

·         Prepares required reports for Administration, The Joint Commission, and other authorized requesters in a timely manner, often involving surveying of other facilities.

·         Assists in maintaining an up-to-date roster of Medical Staff members and communicates changes on a timely basis to provide current information to staff.

·         Maintains current verification of professional liability insurance coverage, state license, DEA, board certification, ACLS, NRP, and other certifications as may be required by the Medical Staff Bylaws.

·         Ensures implementation of new policies, procedures, or problem solutions generated by the Medical Staff.

·         Demonstrates a working knowledge of the Medical Staff Bylaws and Rules & Regulations.

·         Performs Medical Staff correspondence and chart review transcription for Service Chief and officers, as needed.

·         Maintains the MIDAS Seeker credentialing database.

·         Enters results of peer review for quality assurance events (QAE) into MIDAS Care Management.

·         Assists in maintaining Ongoing Professional Practice Evaluation and Focused Professional Practice Evaluation records on the Medical Staff.

·         Assists the Community Relations Department in publishing a photo roster of Medical Staff.

·         Processes reference request letters from other hospitals and health care institutions.

·         Prepares request for Data Bank.

·         Demonstrates ability to work in a team situation

·         Answers voicemail and e-mail promptly, and returns telephone calls in a timely manner.

·         Other duties as assigned.

Please visit http://www.tuality.org/home/index.php/site/careers/  to view and apply for this position.

Kaiser Permanente | Portland, OR

Medical Staff Credentials Specialist-083079

Job Description

Under the general supervision of the Quality Resource Management Manager and Credentials facilitates responsive, timely, accurate practitioner credentialing & provider assessment. Establishes maintains confidential electronic and paper practitioner credential and quality files; establishes and maintains confidential electronic and paper provider assessment files. Identifies issues, pursues responses, and alerts to Credentials Committee peers. Support Credentials Committee, and Provider Assessment Committee's activities and documentation. Comply w/KPNW Credentialing, Recredentialing policies and procedures. Maintain compliance w/all internal & external regulatory, certifying, & licensing bodies. Assure confidentiality & protection from discovery of credentialing and quality information.

Essential Functions:

• As a member of an integrated team open and process practitioner credential, quality, provider assessment files in compliance w/KPNW Credentialing & Recredentialing Policies, Procedures and QRM desk procedures. Communicate w/NWP and KFHP to obtain human resources providing contract information as inputs to the credentialing and assessment processes. Mail credentialing application packets to applicants & follow-up. Investigate record of previous KPNW credentialing. Maintain electronic file record accurately w/agreed formats for style, case, & professional language. Assess need for delineation of privileges; facilitate applicant & chief to achieve accurate completion of delineations. Assure complete, rapid and service-oriented initial practitioner credentialing, privileging, and provider assessment within constraints of due-diligence credentialing practices and KPNW Policies. Issue status reports to NWP and KFH/P on progress and potential credential date. Assure complete accurate service-oriented reappointment and reassessment within constraints of sound credentialing practices and KPNW Policies & Procedures.

• Prepare credential, assessment & quality paper and electronic files for chief of service, Identify, flag issues of concern, work w/chiefs and peers. Prepare lists, reports, documents, agendas. Track open issues and follow-up on action items. Assure tracking, follow-through, stamping and closure of paper and electronic files. Report to Executive Committees & Boards of Directors
• Verify and re-verify practitioner credentials. Utilize recent primary sources to verify education, experience, work history, privileges, insurance, malpractice history, site visits, board certification, license, certification, NPDB, HIPDB, DEA, Medicare & Medicaid opt out and sanctions. Pursue delinquent verifications & responses from outside entities. Obtain information from the applicant on additional certifications: ACLS/NRP/PALS. Process name and address changes in accordance w/department policy. Enter verifications & responses in paper and electronic files. Identify issues, resolution & maintain audit trail
• Maintain documentation and files survey-ready. Prepare Internal and external audits & surveys to present. Meet w/auditors & accreditors
• Identify need for procedures, create flow diagram, maintain regional Recredentialing Policies & Procedures, desk procedures, and credentialing/organizational assessment forms that meet the standards of state and federal legislation
• Support customers created by credentials delegation agreements. Provide reappointment packets to plan hospitals in accordance w/MOU
• Train, educate, elicit support, and cooperation

Basic Qualifications:
• Minimum 1 year of experience in medical staff credentialing and privileging including assembly of quality files
• Minimum of associate's degree or certificate of training in credentialing; NAMSS CPMSM or CPCS certificate, or equivalent experience and willingness to pursue certification at earliest opportunity
• NAMSS CPCS, or CPMSM maintained or willingness to obtain at earliest possible time and to maintain
• Familiar with NCQA, JCAHO standards, state/federal requirements regarding credentialing and organizational assessment
• Familiar with National Practitioner Data Bank/Healthcare Integrity and Protection Data Bank requirements, reporting processes and timelines
• Excellent verbal and written communication and human relations skills. Proven ability to establish and maintain effective working relationships with various levels of management, co-workers, subordinates, interregional employees, medical staff, medical/professional boards, and representatives from outside services/agencies
• Demonstrated ability to manage various projects simultaneously and accurately in order to meet multiple deadlines
• Demonstrated computer proficiency, especially with office automation and credentialing software
• Demonstrated attention to detail
• Ability to work in a fast-paced environment involving frequent changes in processes and procedures
• Documented excellent attendance record

Preferred Qualifications:
• Minimum 2 years experience credentialing
• Bachelor's degree or equivalent education and work experience
• Previous experience preparing for and participating in JCAHO, NCQA or other external surveys
• Working knowledge of NCQA and JCAHO medical staff, credentialing and organizational assessment standards
• Working knowledge and experience of office automation system, Windows, Excel,
Access and credentialing software
• Customer service oriented verbal and written communication skills
•Excellent problem solving skills

Click Here to Submit your Resume

Clinical Privileges Coordinator-094774

Description
 
Under the general supervision of the Credentials Manager, plays a critical role in assisting Kaiser Foundation Hospitals (KFH) in maintaining Joint Commission accreditation, and preparing for internal and external surveys, audits and reviews. The Clinical Privileges Coordinator oversees the process for developing and granting clinical privileges at KFH facilities.

Essential Functions:
PRIVILEGE DELINEATIONS
• Keeps abreast of regulatory and accreditation standard changes related to credentialing and clinical privileges to assure KPNW policies and procedures consistently meet and/or exceed requirements
• Maintains a thorough knowledge of, and ability to interpret accreditation standards, processes and regulatory requirements
• Works collaboratively with department chiefs/designees to develop/revise privileging criteria that meets Joint Commission and CMS regulations
• Works collaboratively with department chiefs/designees to develop/revise privilege delineation forms by developing and using laundry lists, core privileges and competency data
• Works collaboratively with department chiefs/designees to develop/revise proctor forms
• Conducts research on criteria for new clinical procedures; provides research data and findings to department chief to assist the chief in making an informed decision
• In areas of complex issues, conducts second level reviews of requests for clinical privileges to assure the practitioner meets the criteria SURVEYS & AUDITS
• Participates in preparations for audits and surveys; participates in credentialing interviews related to privileging activities
• Participates in annual audit of hospital professional staff appointment/reappointment processes conducted by Program Office staff on behalf of KFH/KFHP Boards
AUDITING & ANALYSIS
• Conducts exception tracking of data entry of privileges into the Cactus database and Practitioner Privilege Delineation intranet site
• Track and trend audit results; use audit results to identify areas of deficiencies where training is needed

Qualifications
 
Basic Qualifications:
• A minimum of 5 years of experience in credentialing and/or medical staff services
• Experience in preparing for and participating in TJC, NCQA and/or other external surveys
• Experience with negotiations and collaboration with medical staff leaders and credentialing support staff
• Experience with TJC, NCQA, CMS standards related to Medical Staff and/or Credentialing
• NAMSS CPCS and/or CPMSM Certification maintained or willingness to obtain at earliest possible time and maintained or a different but relevant certification; manager may use discretion if applicant has previously been certified but has voluntarily let certification lapse due to personal reasons
• Microsoft Office and web based products
• Credentialing software functionalities
• Demonstrates customer-focused service skills
• Demonstrates ability to act independently and in collaboration with others
• Demonstrates time management, organization, and prioritization skills
• Demonstrates ability to exercise high degree of initiative, decision making and good judgment when independent action is essential in the performance of the job
• Demonstrates professional, cooperative, courteous and supportive behavior with team focus
• Demonstrates ability to adapt to flexible work situations and frequent interruptions while meeting established deadlines
• Demonstrates strong problem solving skills
• Demonstrates keen attention to detail and follow-through, results oriented
• Demonstrates excellent verbal & written communication and human relation skills
• Demonstrates work record of dependability, timeliness and good attendance
 
Preferred Qualifications:
• A minimum of 7 years of experience in credentialing and/or medical staff services
• Previous experience preparing for and participating in TJC, NCQA and/or other external surveys
• Two years of college plus substantial focused continuing education relative to clinical privilege development and accreditation standards
• NAMSS CPCS and/or CPMSM Certification
• Accreditation and regulatory, federal and state credentialing requirements
• Credentialing software functionalities
• Proficient in CACTUS software, and software associated with paperless credentialing, i.e., Adobe, scanning modules, etc.

Salary Range:
$52,400 - $69,200

Primary Location
: Oregon-Portland-Kaiser Permanente Building 500 NE Multnomah St.
 
Scheduled Hours (1-40)
: 40
 
Shift
: Day
 
Working Days
: Mon - Fri
 
Working Hours Start
: 8:00AM
 
Working Hours End
: 5:00PM
 
Schedule
: Full-time
 
Job Type
: Standard
 
Employee Status
: Regular
 
Employee Group
: None
 
Job Level
: Individual Contributor
 
Job
: QA / UR / Case Management
 
Public Department Name
: Credentialing/Quality Resource Management
 
Travel
: No
 
Job Eligible for Benefits
: Yes 
  
External hires must pass a background check/drug screen.  We are proud to be an equal opportunity/affirmative action employer.

Credentialing Specialist | Temporary, Full-Time  |  2 positions available

Create your legacy.

Peace Health Southwest Medical Center | Vancouver, WA

Director of Medical Staff Services

Spirit of Healing: PeaceHealth Southwest

Evidence Based Care, Every Time, Every Touch

Quality of Care

The Patient Experience

Evidence Based Leadership

If these ideas resonate with you, join us at PeaceHealth Southwest as our Director of Medical Staff Services.

Make a difference today!

Visit our website at www.swmedicalcenter.org to apply or contact Beth Novak, Recruiter at 360.514.3073.

PeaceHealth Southwest Washington Medical Center

Vancouver, Washington

Regence Credentialing | Portland, OR

Credentialing Specialist

Bring your regulatory expertise to the following role:

Responsible for the implementation, management and coordination of the credentialing and re-credentialing processes based on Regence Credentialing Policies and other Regulatory requirements.