Credentialing Coordinator, Ventura County Health Care Agency, Ventura & Santa Paula, CA

Posted on August 29th, 2022

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:

This classification is allocated to the Ventura County Medical Center and is 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.

PAYROLL TITLE: Credentialing Coordinator I 

For this competitive process, applications will be promptly screened for minimum qualifications (MQs). The applications meeting the MQs will then quickly be scored and referred to the hiring department for the Selection process.
 
EDUCATIONAL INCENTIVE:  Some positions may be eligible for educational incentive depending on the applicable memorandum of agreement and the needs of the department. This incentive may be 2.5%, 3.5%, or 5% for incumbents in eligible positions based on completion of an Associate's, Bachelor's, or Master's degree that is not required for the classification.

BILINGUAL INCENTIVE: Some positions may be eligible for bilingual incentive depending on the applicable memorandum of agreement and the needs of the department. To qualify for this incentive, incumbents in eligible positions must take and pass the applicable bilingual fluency examination.

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

Credentialing Coordinator I is represented by the Service Employees International Union (SEIU) and is eligible for overtime compensation..

TENTATIVE SCHEDULE
OPENING DATE: 8/4/22
CLOSING DATE: Continuous and may close at any time; therefore, the schedule for the remainder of the process will depend upon when we receive a sufficient number of qualified applications to meet business needs.

EXAMPLES OF DUTIES

Duties may include but are not limited to the following:

• Maintains knowledge and compliance with all regulatory and accrediting requirements;
• Processes initial and reappointment applications, checking for completeness and accuracy, including primary source verification of confidential and sensitive practitioner information;
• Ensures 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;
• Maintains credentialing database (MD Staff) with current practitioner information;
• Audits files based on internal standards and regulatory requirements;
• Monitors and reports application status and provide appropriate correspondence as appropriate;
• Assists with development and maintenance of Medical Staff delineation of privilege forms;
• Coordinates and record assigned medical staff committee meetings;
• Protects 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;
• Maintains professional working relationship with Medical Staff, organization departments, clinics, and outside facilities;
• Works independently with minimal supervision to meet specified timeframes;
• Adheres to organization policies and procedures; and
• Performs other related duties as required.

TYPICAL QUALIFICATIONS

These are entrance requirements to the exam process and assure neither continuance in the process nor placement on an eligible list.

EDUCATION, TRAINING, and EXPERIENCE

• 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.

OTHER REQUIREMENTS:
This position may be subject to State Health Officer Orders regarding vaccine verification and/or testing. These requirements are a condition of employment. Depending on assignment and work location(s), successful candidates for this position will be required to submit proof of vaccination and/or booster against COVID-19 or request an exemption for qualifying medical or religious reasons during the onboarding process.

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 delegated health plan credentialing audits .

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: This is a continuous recruitment and may close at any time; therefore, apply as soon as possible if you are interested. Your application must be received by County of Ventura Human Resources in Ventura, California, no later than 5:00 p.m. on the closing date.

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.

Note to Applicants: It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications. A resume and/or other related documents may be attached to supplement the information in your application and supplemental questionnaire; however, it/they may not be submitted in lieu of the application.

LATERAL TRANSFER OPTION: 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%:
A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire. The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining who are the better qualified among those who have shown that they meet the stated requirements. In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the department. Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process.

ORAL EXAMINATION - 100%: A job-related oral examination will be conducted to evaluate and compare participating examinees' knowledge, skills, and abilities in relation to those factors which job analysis has determined to be essential for successful performance of the job. Examinees must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list.

NOTE: The selection process will likely consist of an Oral Exam, which may be preceded or replaced with the score from a Training and Experience Evaluation (T&E), contingent upon the size and quality of the candidate pool. In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. 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 questions within the application are completed with care and diligence. 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.

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.