Credentialing Coordinator I/II, Ventura County Health Care Agency, Ventura County, CA

Posted on October 20th, 2021

POSITION INFORMATION
Under general supervision, is responsible for coordinating all aspects of the privileging and credentialing process of the licensed independent practitioners (LIPs) in accordance with the Medical Staff Bylaws, Rules & Regulations, Policies & Procedures, The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), and National Committee for Quality Assurance (NCQA) accrediting standards and regulatory requirements.

Distinguishing Characteristics:
These classifications are allocated to the Ventura County Medical Center and are characterized by responsibility for analyzing and interpreting numerous regulations to which the medical staff bylaws, rules, regulations, policies, and procedures must conform. These positions are also responsible for advising all Medical Staff departments and Committees of any change or standard that impacts quality of care and Medical Staff administrative operations.

APPROXIMATE SALARIES

• Credentialing Coordinator I: $24.86 - $34.87 per hour
• Credentialing Coordinator II: $2,188.38 - $3,069.14 biweekly
• $4,310.80 - $6,649.07 Monthly
• $51,729.60 - $79,788.80 Annually

AGENCY/DEPARTMENT:
Health Care Agency - Ventura County Medical Center

EDUCATIONAL INCENTIVE:
Some positions may be eligible for an educational incentive of 2.5%, 3.5%, or 5% based on completion of an Associate's, Bachelor's, or Master's degree that is not required for the classification.

BILINGUAL INCENTIVE:
Incumbents may also be eligible for bilingual incentive pay depending upon operational needs and certification of skills.

Credentialing Coordinator I/II is represented by the Service Employees International Union (SEIU). The I level is eligible for overtime compensation; the II level is exempt from overtime compensation.

EXAMPLES OF DUTIES

Duties may include but are not limited to the following:

• Maintain knowledge and compliance with all regulatory and accrediting requirements;
• Process initial and reappointment applications, checking for completeness and accuracy, including primary source verification of confidential and sensitive practitioner information;
• Ensure that all credentials files are current and complete pursuant to expiration date of medical licenses, board certification, professional-liability insurance coverage, DEA and other pertinent information, per bylaws, rules and regulations, and policies and procedures;
• Maintain credentialing database (MD Staff) with current practitioner information;
• Audit files based on internal standards and regulatory requirements;
• Monitor and report application status and provide appropriate correspondence as appropriate;
• Assist with maintenance of Medical Staff delineation of privilege forms;
• Coordinate and record assigned medical staff committee meetings;
• Protect all credentialing information and files with strict confidence and limited access according to regulatory standards;
• Participates in preparation for health plan annual audits and reports;
• Maintain professional working relationship with Medical Staff, organization departments, clinics, and outside facilities;
• Work independently with minimal supervision to meet specified timeframes;
• Adhere to organization policies and procedures; and
• Perform other related duties as required and assigned.

At the higher level, duties also include but are not limited to the following:

• Assist with development of Medical Staff delineation of privilege forms;
• Serve as lead worker in preparing for health plan annual audits and completing periodic health plan reports.
• Perform other related duties as required and assigned.

TYPICAL QUALIFICATIONS

EDUCATION, TRAINING, and EXPERIENCE

Credentialing Coordinator I:

• Current National Association of Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) or actively pursuing certification and certification obtained within two (2) years of eligibility to sit for the exam.
• Intermediate computer skills using Microsoft products and web-based queries.

Credentialing Coordinator II:

• In addition to the above-listed requirements for the I level, the II level requires previous hospital medical staff and/or managed care credentialing experience.

DESIRED

• Previous hospital medical staff or managed care credentialing experience.
• Experience with credentialing software.

Knowledge, Skills, and Abilities

Working knowledge of TJC, NCQA, and CMS credentialing and privileging standards and experience with provider and/or health plan credentialing and, for level II, delegated health plan credentialing agreements.

Ability to manage and meet multiple priorities and competing deadlines; read and interpret complex documents, reports, and data; effectively and professionally communicate with providers, outside organizations, and staff, both verbally and in writing; and exercise sound spelling, grammar, and clear written communication.

Problem solving and organization skills with attention to detail.

RECRUITMENT PROCESS

FINAL FILING DATE:
Applications must be received by County of Ventura Human Resources no later than 5:00 p.m. on Friday, October 29, 2021.

To apply online, please refer to our web site at www.ventura.org/jobs. If you prefer to fill out a paper application form, please call (805) 654-5129 for application materials and submit them to County of Ventura Human Resources, 800 South Victoria Avenue, L-1970, Ventura, CA 93009.

Sufficient information must be provided under the Education/Work experience portion of the application and supplemental questionnaire to thoroughly and accurately demonstrate your qualifications in order to determine eligibility. A resume may be attached to supplement your responses in the above-referenced sections; however, it may not be substituted in lieu of the application.

NOTE TO LATERAL TRANSFER CANDIDATES:
If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here for additional information.

SUPPLEMENTAL QUESTIONNAIRE - qualifying:
All applicants are required to complete and submit the questionnaire for this exam AT THE TIME OF FILING. The supplemental questionnaire may be used throughout the exam process to assist in determining qualifications for the position. Failure to complete and submit the questionnaire may result in removal of the application from further consideration.

APPLICATION EVALUATION - qualifying:
All applications will be reviewed to determine whether the stated requirements are met. Applicants meeting the stated requirements will be invited to continue to the next step in the examination process.

TRAINING & EXPERIENCE EVALUATION - 100%:
The selection process will consist of a Training and Experience Evaluation (T&E) exam. A T&E is a structured evaluation of the job application materials submitted by an applicant, including the written responses to supplemental questions. The T&E is a method for determining the better qualified applicants among those shown to meet the stated requirements. Using a T&E, applicants may be scored or ranked according to criteria that most closely meet the business needs of the department. Applicants are typically scored or ranked in relation to one another; consequently, when the pool of applicants is exceptionally strong, some qualified applicants may receive a score or rank which is moderate or even lower resulting in them not being advanced in the process. Applicants must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list.

NOTE:
In a typical T&E, your training and experience are evaluated in relation to the background, experience, and factors identified during a job analysis as needed at the time of hire for successful job performance. For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities. It is also highly recommended that the supplemental questionnaire is completed with care and diligence. Be clear and thorough in your responses to demonstrate the scope of your knowledge and experience in each area. Responses such as "See Resume" or "Refer to Resume" are not acceptable and may disqualify an applicant from further evaluation.

If there are three (3) or fewer qualified applicants, a T&E exam may not be conducted. Instead, a score of seventy percent (70%) will be assigned and the qualified applicants will be placed on the eligible list.

Applicants successfully completing the examination process may be placed on an eligible list for a period of one (1) year. The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-Term), Intermittent, Per Diem Pool, and Extra-Help vacancies. There is currently one (1) anticipated Regular vacancy.

NOTE:
If appointed at the lower level, incumbent may be promoted to the higher level without further exam upon meeting the minimum requirements, demonstrating satisfactory performance, and in accordance with the business needs of the department.

BACKGROUND INVESTIGATION:
A thorough pre-employment, post-offer background investigation which may include inquiry into past employment, education, criminal background information, and driving record may be required for this position.

For further information about this recruitment, please contact Laura Carlson by email at laura.carlson@ventura.org or by telephone at (805) 477-5497.

An Equal Opportunity Employer