Director National Credentialing, Kaiser, Oakland, CA

Posted on October 10th, 2019

Passion + Vision + Integrity = Excellence 
Ensure consistency and the highest ethical standards across our entire organization. Our quality assurance team drives ongoing improvement by fostering an environment of support, providing technical and specialized consultative services, and inspiring ongoing excellence.
 

In collaboration with the leaders and stakeholders across all eight of Kaiser Permanente regions, you will manage projects and programs to achieve an effective and reliable infrastructure to meet the goals and objectives of hospital and health plan quality oversight. In this role, you will be accountable for managing all phases of improvement projects including design, prioritization, staffing, development, implementation, analysis, metrics, and reporting. You will also prepare reports on appropriate oversight areas including patterns, trends, and organizational risk as well as coordinate and deliver education, training, and communication programs. You will be responsible for developing program-wide templates for appropriate policies and procedures and ensuring implementation for consistent programs and infrastructures across the enterprise. In addition, you will function as an expert authority to all entities in regions and will share accountability of outcomes and performance for all regions and the enterprise in oversight areas. 

Qualifications Include: 

• At least three years of management experience 
• At least eight years of related experience
• A bachelor’s degree in a related field or four years of directly related experience with a high school diploma or GED  
• Certified Provider Credentialing Specialist (CPCS) or the ability to obtain one within twelve months of hire
• Certified Professional Medical Services Management (CPMSM) or the ability to obtain one within twelve months of hire
• Advanced knowledge of own area of functional responsibility and working knowledge of multiple related functions 
• Knowledge and broad expertise of policies, practices, and systems 
• In depth knowledge with demonstrated success in change management and implementation of programs across disciplines and geographical locations 
• The ability to work in a Labor/Management Partnership environment 

Preferred Qualifications Include: 

• Five years of directly related credentialing experience preferred 
• A master’s degree in a directly related field preferred 
• Certified Professional Medical Staff Management (CPMSM) preferred 

For immediate consideration, please visit http://kp.org/careers for complete qualifications and job submission details, referencing job number 829931.

Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. 

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

This position supports Kaiser Permanente’s code of conduct and compliance by adhering to all laws and regulations, accreditation and licensure requirements, and internal policies and procedures.

kp.org/careers

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Medical Staff Services Manager, Petaluma Valley Hospital, Sonoma County, CA

Posted on October 1st, 2019

Have you ever considered living in beautiful Sonoma County, CA? With hundreds of wineries, lot of warm sunshine, miles of rugged Pacific coastline and multiple nature parks, it is a dream location to call home!

Petaluma Valley Hospital is approximately 40 miles north of San Francisco just off the Highway 101 corridor in southern Sonoma County in the town of Petaluma. Petaluma is now known as one of the top 100 places to raise a family. This 80-bed acute and critical care hospital is ranked in the top 10% of Hospitals in Northern California for best practices. It's a great time to grow your career as a Medical Staff Services Manager!

Job Summary: 
Facility supervision for medical staff services including meeting management, credentialing/re-credentialing/privileging oversight, medical staff bylaws, rules and regulations, policies and procedures development and revision. Responsible for departmental operations, budgeting, planning, development of information systems and coordination of information flow with other departments and the medical and allied health staffs. 

Area Responsibilities: 

• Oversees Medical Staff Services including personnel, planning, budgeting, directing, staffing, evaluation, and the development of policies and procedures to assure accomplishment of strategic goals for the department and organization.
• Monitors the process for applications, reapplications and privileging for medical and allied health professional staff for the entity medical staff services.
• Provides administrative consultation to the medical staff leadership for grievance procedures and the fair hearing process in accordance with the medical staff bylaws and the rules and regulations and works with legal counsel as needed.
• Oversees the peer review process and facilitates corrective actions.
• Oversees and assures compliance of monthly Medical Staff department, section and committee meetings as addressed in the Medical Staff Bylaws, Rules and Regulations.

Hospital Responsibilities:

• Attends meetings and participates on committees as required. Records and summarizes meeting minutes and performs appropriate follow up. Maintains as confidential, accurate and up to date Medical Staff Department, Committee and Section minutes. Keeps the MEC/EC apprised of medical staff activity as needed, coordinator medical staff meeting agenda preparation, participant notification, and room and food service scheduling.
• Performs administrative tasks as needed for Administration and Medical Staff and acts as liaison to the Medical Staff Leadership CMO, and the Executive Management Team. .Works with Hospital Administration and the Medical Staff providing resources needed to enable the medical staff fulfill their duties and obligations as defined by TJCA, DHS, CMS and other regulatory agencies, the Medical Staff Bylaws, Rules and Regulations, Policies and as delegated by the Hospitals Board.

Qualifications: 

• Bachelor’s Degree or equivalent of education and/or training.
• 5 years experience in medical staff services in a large, broad-based healthcare environment.
• License/Certification: National Association of Medical Staff Services Certification. as a CPCS or CPMSM.

To Apply: Please email your resume to Elizabeth.allen@stjoe.org.

Medical Staff Credentialing Specialist, Shriners Hospitals, Sacramento, CA

Posted on September 25th, 2019

Shriners Hospitals for Children Northern California, the premier pediatric burn, orthopaedic, spinal cord injury and pediatric subspecialties medical center, is looking for a highly motivated Credentialing Specialist to become part of our Medical Staff.

The successful candidate will be responsible for leading, coordinating, monitoring and maintaining the credentialing and re-credentialing process for Medical Staff and Advance Practice Practitioners;  facilitating all aspects of SHCNC credentialing, including initial appointment, reappointment, expiration process, as well as clinical privileging; and ensuring interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws of California related to credentialing.  

Must have strong organizational skills, good written communication skills, must be able to work independently, analyze data and conduct research while performing the duties of the job. Previous experience with increased responsibilities in management and departmental functions required.  

Certification from the National Association of Medical Staff Services as a Certified Provider Credentialing Specialist (CPCS) is preferred.

SHCNC offers a competitive salary and benefit package, including continuing education and professional development opportunities. Other considerations include, free parking, team approached interdisciplinary care, friendly environment and the satisfaction that our patients are receiving the best care available at no cost to them.
    
Submit resume to Human Resources, 2425 Stockton Blvd, Sacramento, CA  95817, fax to 916-453-2388, or email ncal.jobs@shrinenet.org. To learn more about our hospital, visit our website at www.shrinerschildrens.org. EOE/Drug Free Workplace

Lead Credentialing Coordinator, City of Hope, Duarte, CA

Posted on September 24th, 2019

About City of Hope

City of Hope, an innovative biomedical research, treatment and educational institution with over 6000 employees, is dedicated to the prevention and cure of cancer and other life-threatening diseases and guided by a compassionate, patient-centered philosophy.

Founded in 1913 and headquartered in Duarte, California, City of Hope is a remarkable non-profit institution, where compassion and advanced care go hand-in-hand with excellence in clinical and scientific research.  City of Hope is a National Cancer Institute designated Comprehensive Cancer Center and a founding member of the National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers that develops and institutes standards of care for cancer treatment.

Position Summary:

To provide advice and guidance to the credentialing coordinators. Use tracking system to ensure all payer/facility enrollment and reenrollment are done accurately and completed in accordance with the timelines set forth by the department. Furthermore, the lead credentialing coordinator is responsible to act on behalf of the Credentialing Manager during his/her absence.

Key Responsibilities include:

Lead Functions:

• Assist the manager to develop, implement and enforce policies and procedures to ensure quality of credentialing function
• Works closely with staff to resolve any provider enrollment matters.
• Ensures staff is working in adherence to internal policies and procedures.
• Demonstrates teamwork and provides assistants with special projects when assigned.
• Conducts random work audits for the purposes of assessing proper standard work is being followed. 

Credentialing Functions: 

• Ensures that all provider files are complete with current licensing and certification documents.
• When appropriate, works cooperatively with administrative staff at the City of Hope National Medical Center in order to obtain pertinent information necessary for credentialing.
• Manages provider profiles in practice management system.
• Completes credentialing, re-credentialing and medical staff applications for clinical staff and submits information to hospitals, commercial and government payers in a timely manner, as needed.
• Maintains a positive image when dealing with departmental personnel and other City of Hope employees.
   

Basic education, experience and skills required for consideration: 

• High School diploma.
• Five (5) or more years of experience in a hospital, medical group or Independent Practice Association (IPA) with specific knowledge of third party payer and/or medical staff credentialing. 

Required Certification/Licensure: 

• Current CPCS certification or CPMSM certification. 

City of Hope is committed to creating a diverse environment and is proud to be an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, or status as a qualified individual with disability.

Apply online at: https://aa067.taleo.net/careersection/ex/jobdetail.ftl?job=10003912&lang=en

Credentialing Assistant/Specialist/Coordinator, Medical Staff Services, Greeley, Mission Viejo, CA

Posted on September 11th, 2019

About Greeley
The Greeley Company is a prestigious, highly regarded professional services organization with a 30-year history of partnering with hospitals and healthcare organizations nationwide, offering physicians and hospital leaders consulting and other services to solve various administrative challenges allowing them to continue delivering high-quality, cost-effective patient care.

Our Credentialing Assistant position is located at Mission Hospital in Mission Viejo, California, and reports to our sought-after Director, Glenda Zeismer.  It is designed for the medical staff professional interested in growth...growth as an individual professional, growth within the Greeley Company, growth in experience, knowledge base and in position. 

Our Local Team:
Our team at Mission is known for its “succeed together” mindset, co-workers who go above and beyond to support each other’s success and lastly, having an incredibly supportive and sought-after leader – this is a team where your contributions are valued and appreciated!

Our Partner:
Mission Hospital is a Joint Commission accredited, full-service acute care hospital with 523 licensed beds and serves the needs of the south county adult and pediatric communities as a verified Regional Level II Trauma Center, inpatient mental health provider and designated Stroke Receiving Center.  CHOC Children’s at Mission is a separately licensed hospital within the hospital.

Job Description:
Our credentialing assistant coordinates internal and external activities of the Medical Staff including medical staff meeting management, proctoring and specialty specific privileges and monitoring. This position Assists Medical Staff Officers, departments and committees in the pursuit of their responsibilities as defined in the Medical Staff Bylaws and Rules/Regulations.

General Duties:

• Primary responsibilities are to assist the department in creating reports of credentialed physician’s activity [i.e. case logs, gathering OPPE data]
• Maintain and update accurate credentialing database
• Create and maintain rosters
• Respond to affiliation verifications/requests, communicate results and status with applicants and management
• Maintain computer and parking access
• Create and maintain the ER Call Schedules
• Serve as the point person for the coordination of special functions/activities.

Requirements:

• A service-minded, team oriented, solutions driven mindset

Skill-sets for Success:

• Highly organized, detailed oriented and self-motivated
• Working knowledge of Microsoft Office
• Time management skills and ability to meet deadlines
• Professional written and verbal communication skills
• High level of confidentiality

Location:
27700 Medical Center Road, Mission Viejo, CA 92691

Apply for Credentialing Assistant / Coordinator (Medical Staff Services) using the link below: 
https://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=af34e79a-9c7c-4bd7-bf93-2bfad5b44cbc&ccId=19000101_000001&jobId=295519&lang=en_US&source=CC4

Provider Enrollment Manager, TeamHealth SE, Pleasanton, CA

Posted on August 29th, 2019

JOB DESCRIPTION OVERVIEW:
The Provider Enrollment Manager has overall responsibility to assists with planning, organizing, and direct provider enrollment activities as assigned by Provider Enrollment Director and Chief Financial Officer.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Ensures that all assigned Billing Groups and Providers are in compliance with rules and regulations regarding the application for, obtaining and system maintenance of provider numbers for various carriers.
• Manages information maintenance of provider numbers, National Provider Identifier (NPI), requirements of third party carriers for provider numbers, and conveys necessary information on a timely basis to the corporate PETF and Billing Center management staff.
• Manages maintenance of physician files in the billing system, specifically additions, deletions, and changes pertaining to physicians and other pertinent information.  This includes a  monthly review of group memberships.
• Directs the Provider Enrollment Assistant and Provider Enrollment Reps I & II on the proper procedures regarding the conduct of provider enrollment activities, manages day-to-day workflow and productivity.
• Assists with training new staffs, leads, and motivates staff.
• Possesses a thorough understanding of and maintains all aspects of the applications used, including Team Works and IDX AES.
• Interrelates with Recruiters, Credential Coordinators, VP of  Physician Services, and VP of Operations to facilitate the provider application process,outstanding billing applications, credentials, and NPI.
• Reports to Provider Enrollment Director and division on issues that can enhance provider enrollment and on problem physicians and carriers.
• Manages Denial Management System (DMS) workflow for the department to ensure Provider Enrollment Reps I & II are completing by the suggested deadline.
• Assists with Supervising the maintenance of source document files for each state in which TeamHealth has contracts or otherwise performs medical billing.  The source document file consists of applications utilized in the provider enrollment process.
• Acts as liaison with the Division Physician Services Group and VP of Operations to obtain current information on all new physicians and changes in the group.
• Provides education to the management staff, Medical Director’s, Provider Enrollment Assistant, and Provider Enrollment Representatives I & II pertaining to changes in provider enrollment rules and regulations.
• Manages the overall day-to-day workflow and communicates with the Provider Enrollment Director on issues or obstacles inhibiting performance.
• Produce the Provider Hold Report weekly and distributes to management staff and Billing Centers.
• Produce Outstanding Billing Applications report to identify issues.
• Assists with Measuring Provider Enrollment productivity by meeting with staff monthly to discuss issues.

QUALIFICATIONS / EXPERIENCE:    

• Ability to work with a database and optical scanning.
• Effective oral and written communication skills.
• Good decision-making, analytical, managerial, and problem-solving skills.
• Ability to handle to develop a plan of action to handle new contracts.
• Degree in business or management related field, preferred.
• Three years of experience in medical billing with specific experience in provider enrollment, or physician credentialing.
• Training classes, and seminar attendance may require travel.

SUPERVISORY RESPONSIBILITIES:

• Manages Provider Enrollment Assistant and Provider Enrollment Representatives I  and II

PHYSICAL / ENVIRONMENTAL DEMANDS:

• General office environment.
• Job performed in a well-lighted, modern office setting;
• Occasional lifting/carrying (10 pounds or less);
• Prolonged sitting; with prolonged work in a computer/PC;
• Occasional work in evenings and on weekends; 
• Moderate stress;
• May require moderate overnight travel;
• Overtime may be required and can be mandated by Management.
• Ability to work well in fast-paced environment.

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.

DISCLAIMER:

The above information on this description has been designated to indicate the general nature and level of work performed by employees within this classification.  It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job.

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.

APPLICANTS APPLY TO:

Amanda Panell, SHRM-CP
Manager, Human Resources
Southeast and LifePoint Group
TeamHealth

1431 Centerpoint Blvd. Suite 100 | Knoxville, TN 37932
work: 865.293.5262 | fax: 865.291.3263 | amanda_panell@teamhealth.com

Medical Staff Coordinator, Huntington Hospital, Pasadena, CA

Posted on August 5th, 2019

Job ID: 105364
Category: Clerical
Department: Medical Staff
Shift: Days
Hours: Full Time

When you join Huntington Hospital in Pasadena, CA, you are aligning yourself with an organization whose values drive our philosophy of care. Our focus on delivering quality, service, and cutting edge care, enables Huntington Hospital to be an organization committed to patient outcomes-not the bottom line. More importantly, it empowers you to enact change and deliver the results that continuously improve our ability to provide our community with care.
 
The Medical Staff Coordinator is responsible for medical staff services functions to meet the needs of the medical staff and is responsible for Credentialing, Recredentialing and Meeting Management. Works with Hospital Administration and the Medical Staff to direct and coordinate administrative support and provide resources needed for the medical staff to enable them to fulfill their duties and obligations as defined by the Medical Staff Bylaws, Rules and Regulations and policies and procedures. Ensures compliance with The Joint Commission Standards, Title 22 Regulations and other regulatory agencies. This position requires flexibility of hours.

Experience/Training: 
Working knowledge of Medical Staff principles and operations specific to regulatory expectations. Comprehensive understanding of medical terminology. Excellent verbal and written communication skills, independent problem solving and decision making skills, critical thinking ability, attention to details and high degree of accuracy. Excellent customer service skills. Computer literacy to include extensive word processing skills, Microsoft Outlook, Word, Excel, PowerPoint, Medical Staff Software. At least three years experience in Medical Staff Services Department, with meeting management.

Education: 
Minimum High School Diploma. Bachelor’s degree preferred.

Licenses/Certifications:

CPMSM or CPCS certification preferred on entry. Required within 2 years of hire/transfer.

Skills:

Problem solving and conflict resolution skills are necessary. Ability to establish prioritize work assignments. Good working knowledge of medical staff organization. Computer and database literacy is required. Ability to express ideas effectively, orally and in writing. Must possess organizational skills.

Innovating the delivery of healthcare as the San Gabriel Valley region’s only Level II Trauma Center and Level III NICU, Huntington Hospital is a 635-bed non-profit regional medical center. We deliver nationally recognized care across over 90 service areas to our community and beyond. 

Located in downtown Pasadena, you’ll find yourself among charming neighborhoods and a relaxed community that is still close enough to all that L.A. has to offer. So join us, and find out what it’s like to discover Careers at a Higher Level™.

APPLY HERE: https://d.hodes.com/r/tp2?e=se&tv=pixel_tracker&p=web&aid=huntington&se_ca=misc&se_ac=click&se_la=6710&u=https%3A%2F%2Fwww.hhcareers.com%2Fjob%2F9917094%2Fmedical-staff-coordinator-pasadena-ca%2F%3Futm_source%3Dcamss%26utm_campaign%3Dnull%26utm_medium%3Dmcloud-misctags%26utm_term%3D6710_Medical%2520Staff%2520Coordinator%2520posting