Credentialing Associate Jobs in New York (NOW HIRING)

Job Title: Credentialing Specialist

Location: RWJUH Somerset

Department Name: Medical Affairs

Req #: 0000257930

Status: Salaried

Shift: Day

Pay Range: $61,400.00 - $76,900.00 per year

Pay Transparency:

The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.

The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.

A Typical Day

• The Credentialing Specialist is accountable for performing duties related to credentialing and privileging licensed independent practitioners (initial and reappointment)
• Facilitates Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) processes in accordance with regulatory standards
• Handles with discretion issues that are significant complex multidisciplinary sensitive and confidential
• Possesses and develops a strong grasp of the medical staff operations and the cultures of each affiliated institution and works to collaborates with central Medical Staff Office to facilitate timely completion of credentialing processing
• Oversees and assists with application management, audit, traffic through approval queues and committee presentation,
• Analyze verification information to include identifying red flag and or adverse information and notifying MSO leadership (local/central) in accordance with policie
• Oversee the monitoring of expiring information such as but not limited to DEA license professional liability insurance and specialty board certification status maintain and update credentials files
• Management of database entries for accuracy and completeness
• Maintenance of electronic files as required
• Effective and timely communication with central medical staff office personnel
• Timely and accurately prepare credential files for audit and submission to the Chiefs, Chairs and Committees
• Maintain a working knowledge of relevant regulatory standards ie TJC DNV and NCQA state and federal requirements and applicable Medical Staff Bylaws
• Assist with the development and implementation of credentialing and recredentialing workflows to ensure efficient and effective alignment of processes
• Assist in the development or revision of credentialing related forms
• Participation in special project teams as assigned
• Training of new staff as assigned credentialing procedures software and workflows
• Enforcement of internal procedures and controls and problem resolution
• Takes a proactive role in monitoring and assisting in improving team productivity
• Exemplifies a culture of excellence effective communication and collaboration and customer service with Medical Staff Office MSO leadership and staff internal and external customers providers and clinical and administrative leaders within RWJBarnabas Health
• Continually strives to achieve individual team and departmental goals
• Oversees and assists with application management and verification activities preliminary analysis of application and verification information

This Role Might Be For You If ...

• You have excellent interpersonal and communication skills
• You demonstrate the ability to work under minimal supervision and to adapt quickly to changes within the environment 

To Be Considered

Required:

• Associates degree or combination of education and experience deemed equivalent
• At least two years of experience CVO or Medical Staff Services in an acute healthcare setting, including credentialing and privileging

Preferred:

• Knowledge of credentialing software and associated applications strongly preferred

Certifications and Licenses Required:

• Certified Professional in Medical Staff Management CPMSM or Certified Provider Credentialing Specialist CPCS preferred

Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.