Saint Paul, Minnesota
- Processes and oversees the initial applications for clinical privileges and medical staff membership.
- Coordinates and processes the practitioner reappointment process and incorporates the review of quality management performance reports and data obtained during the Ongoing Professional Practice Evaluation (OPPE) into the reappointment process.
- Performs analysis of supporting documentation ensuring that applications are processed according to established policies and procedures as well as the Medical Staff Bylaws and Rules & Regulations, within the established time frame. Researches and identifies problems/issues regarding data integrity and reports to the Credentialing Director and/or the appropriate medical staff leader(s).
- Assists with accreditation and department of health surveys and attends survey interviews as needed
- Processes requests for additional clinical privileges according to established policy and procedures. Monitors, reviews and revises Delineation of Privilege Forms on a biannual basis.
- Reviews all expirable items and ensures that all practitioner's licenses, DEAs, insurance, certifications, and other expiable items are current, valid and renewed by the practitioner by their due date.
- Processes temporary privilege requests and applications for educational experiences.
- Ensures that all applications have been fully and accurately processed prior to the Clinical Council Chair's review.
- Interacts and communicates with practitioners, clinical council chairs and with various levels of management as necessary regarding credentialing/application processing and practitioner information and communicates information appropriate for the intended audience.
- Maintains knowledge of, and complies with, all relevant laws, regulations and policies, procedures and standards.
- Actively participates in creating and implementing improvements to achieve clinical, satisfaction and/or efficiency outcomes.
- Other duties as assigned and for which I have been trained
- High school graduate or equivalent
- Certified Provider Credentialing Specialist (CPCS) preferred
- Knowledge of analytical and/or statistical theory and applications. Ability to analyze data to interpret and evaluate results, and create reports and/or presentations.
- Experience with Joint Commission, MN Department of Health and CMS survey processes.
- Experience working with medical professionals.
- Knowledge of health care environment, credentialing and medical staff organization.
- Knowledge of Joint Commission and Centers for Medicare/Medicaid Medical Staff Standards.
- Knowledge and skills in data collection, data analysis and interpreting results.
- Knowledge and understanding of clinical events.