St. Luke's Health System is seeking a Certified Credentialing Coordinator to join our Central Verification team. This position offers a remote working environment from anywhere in Idaho or Oregon.
Position SummaryThe Certified Credentialing Coordinator coordinates departmental activities to ensure quality in conducting, maintaining, and communicating physician credentialing, privileging, and primary source verifications.
Determines applicant's initial eligibility for membership/participation. Analyzes application and supporting documents for completeness and informs the practitioner of the application status, including the need for any additional information.
Facilitates the re-credentialing/reappointment process for eligible providers.
Compiles, evaluates, and presents the practitioner-specific data collected for review by one or more decision-making bodies. Processes requests for privileges.
Obtains and evaluates information received from primary sources.
Recognizes, investigates, and validates discrepancies and adverse information obtained from the application, primary source verifications, or other sources.
Participates in ongoing assessment of governing documents (bylaws, rules and regulations), standards and policies to ensure continuous compliance.
Demonstrates a sound knowledge of the subject matter. Subject matter expert.
Understands concepts, key functions, terminology, and work products pertaining to legal, information technology, risk management, and performance concepts.
May verify and document expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
May collaborate with physician leaders to develop and maintain a facility-specific, criteria-based clinical privileging system in accordance with regulatory requirements, accreditation standards, and organizational policies.
May participate in audits of regulatory and/or delegated credentialing entities.
May coordinate meetings of the medical staff organization.
May coordinate and develop provider on-boarding processes (orientation, training activities, and IT access).
May conduct, participate in, and maintain focused and ongoing professional practice evaluation processes for privileged providers.
May facilitate event reporting incidents through the medical staff leadership including documentation of resolution.
May lead and mentor others acting as first point of escalation. Participates in interview, training and onboarding process as needed. Participates in departmental performance improvement initiatives as needed.
Performs other duties and responsibilities as assigned.
Education: Associate's Degree or 2 years' additional experience in lieu of Associate's Degree
Experience: 3 years' relevant experience
Licenses/Certifications: Must hold one of the following: Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM)
Why St. Luke's
A strong, talented staff is at the heart of St. Luke's Health System. We are the state's largest employer with more than 15,000 employees and a medical staff of more than 1,800 physicians and advanced practice providers. We're proud of our people who deliver skilled, compassionate care every day, and are looking to add dedicated individuals who will continue this same tradition of excellence.
*St. Luke's is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.
As the only Idaho-based, not-for-profit health system, St. Luke’s Health System is part of the communities we serve, with local physicians and boards who further our organization’s mission “To improve the health of people in our region.” Working together, we share resources, skills, and knowledge to provide the best possible care, no matter which of our hospitals you choose.