Verification Manager Jobs in Ohio (NOW HIRING)

Legal Entity

Aultman Hospital

Position Summary

The Credentialing Coordinator in the Credentialing Verification Office (CVO) handles the Credentialing for all practitioners on the Medical Staff, including Allied Health Practitioners by processing applications for appointment, reappointment, and requests for new privileges in order to assure the hospital has highly qualified, competent practitioners providing care.

Department Summary

The CVO provides support to the organized Medical Staff, as well as advanced practice providers. The office provides all aspects of credentialing for the Medical Staff and Advanced Practice Providers as required by the accrediting body of the hospital to assure the hospital has qualified and competent providers providing safe care to patients within their training and scope of service.

Qualifications

• High School Graduate or equivalent.

• Associate or Bachelor’s degree in Health Information Management (HIM) or related field is preferred.

• 3 – 5 years of healthcare experience, preferred.

• Proficient in Microsoft office applications.

• Ability to use MD-Staff credentialing software.

Skills

• Must be detail-oriented and highly organized.

• Have ability to communicate effectively.

• Work effectively with coworkers.

• Ability to meet deadlines.

• Must possess time-management skills.

• Ability to function independently.

Responsibilities & Expectations

• Manages initial application process for all Medical Staff and Allied Health Practitioners to include collection, verification, and assessment of information regarding current licensure; education and relevant training; and experience, ability, and current competence to perform requested privileges. Ensures appropriate documentation of required elements and provides timely follow-up of all required information to complete the application.

• Performs all required primary source verifications.

• Identifies red flags (e.g., time gaps, application discrepancies, derogatory information) through thorough analysis of primary source verifications. Conducts appropriate and timely follow-up of verifications and ensures all documentation is available for review in the complete credentials file.

• Compiles complete credentials files for review and recommendation, working directly with; Department Chairs; CEO, VP of Medical Affairs; Assistant Manager, Medical Staff leadership and the Allied Health Credentialing Committee. All applications are processed in a timely fashion as defined by the Medical Staff Bylaws, Rules and Regulations, policies, and accreditation standards.

• Manages the temporary privileges process to ensure that temporary privileges are processed and granted in a manner consistent with the Medical Staff Bylaws, Rules and Regulations, Policies, and accreditation standards.

• Manages the reappointment process for all Medical Staff and Allied Health Practitioners in a comprehensive, well-organized manner to include primary source verifications and analysis of all reappointment documentation.

• Manages clinical privileging process (including requests for additional privileges) through collaboration with Department Chairs, and the Allied Health Credentialing Committee. This includes revising and updating privilege delineation forms and ensuring appropriate clinical privileges are maintained and timely published for each practitioner with defined privilege.

• Interfaces with Quality Department to integrate quality of care and risk management findings into the reappointment processes for practitioners and collaborates with Quality Department regarding ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE) process.

• Understands and participates in Medical Staff and Allied Health Credentialing Disaster Privileging protocol in event of emergency or disaster.

• Maintains a working knowledge of accreditation standards related to Medical Staff and Allied Health Credentialing. Participates in accreditation survey file review as requested, and demonstrates compliance Medical Staff accreditation standards to maintain accreditation.

• Prepares a monthly practitioner activity notice that is distributed to appropriate hospital departments that accurately reflects all approved practitioner revisions as approved by the Board of Directors.

• Provides guidance, support, and education to Medical Staff leadership regarding practitioner credentialing and privileging processes.

• Completes mandatory education and training in order to maintain organization and department specific competencies and requirements.

• Follows hospital and department policies and procedures with special attention to attendance, punctuality, confidentiality, dress code, and display of ID badge, and safety.

• Inputs credentialing data into MD-Staff Credentialing Software to assure accurate record keeping.

• Utilizes Virtual Committee (through MD-Staff) for Department Chairs to review reappointments.

• Coordinates and assists with supplemental appointment and reappointment requirements (ex: using Survey Monkey for required education modules, collecting Quality reports at Reappointment, etc.).

• Assists practitioners and their office staff on completing appointments and reappointments via MD-App.

• Runs reports in MD Staff.

• Coordinates, attends, takes minutes, and does follow-up for the Allied Health and Medical Staff Credentialing meetings.

• Sends out and tracks completion of FPPE requirements for Allied Health practitioners.

• Performs general office duties as needed.

Working Conditions

• Work approximately 8 hours per shift. Primarily Day Shift, occasional evening and weekend coverage.

• Shifts are variable to volume of department. Rotation as needed.

• Hybrid/WFH/In Office schedule available.

• Lunch periods and breaks are coordinated with other staff members to maintain adequate coverage.

• Cross training to other areas in the department to provide coverage as needed.

Hazardous Exposure Category

Category III - Includes tasks that involve no exposure to blood, body fluids, or tissues and Category I tasks are not a condition of employment. The normal work routine involves no exposure to blood; body fluids or tissues (although situations can be imagined or hypothesized under which anyone anywhere might encounter potential exposure to body fluids.) Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency care or first aid or to be potentially exposed in some other way.