Director of Credentialing - is responsible for all aspects of credentialing and re-credentialing of health care professionals. This position ensures all health care professionals are appropriately credentialed, which includes the duty of maintaining current information on file and within the credentialing database. This position primarily works independently, but frequently coordinates with other team members. Main functions include: Maintain up-to-date data for each provider in credentialing databases and online systems; Develops, maintains, and provides new practitioner onboarding & orientation; maintain physician score cards; ensure timely renewal of licenses and certifications and assuring the process of credentialing and other department functions are performed in accordance with bylaws, the DNV and CMS standards.
Community Outreach Liaison - will also serve as a liaison 50% of the period to hospitals and discharge planners to establish relationships to help facilitate placement of swing-bed referrals and overall marketing of established/new ancillary services offered at CCH to top referring physicians. This position will include benchmarks for growth, with incentives offered based on reaching newly established performance metrics agreed upon by the applicant and hospital leadership.
ESSENTIAL FUNCTIONS of this job description include but are not limited to:
Director of Credentialing:
- Supporting the mission, vision, and core values of the organization.
- Coordinate medical staff meetings, taking minutes, and follow up work as may be required
- Directs Medical Staff and Advanced Practice Professional initial credentialing process and provides oversight for reappointment/re-credentialing of providers
- Serves as liaison between the Medical Staff and hospital administration
- Data entry of new applications in the credentialing database
- Maintain working knowledge of standards and State and Federal standards and regulations related to credentialing
- Perform and collect PSV (primary source verification) documentation for licensing, board certifications, proof of professional liability insurance, National Practitioner Data Bank (NPDB) and/or other sources as required based on federal standards, health plan requirements and company credentialing policies
- Maintain the credentialing database and ensure up-to-date information is obtained at all times
- Responsible for monitoring and managing credentialing/re-credentialing requirements and to ensure the collection of all required renewal certifications are on file within the required time frame
- Provide consistent and timely follow-up on all outstanding credentialing/re-credentialing files
- Prepare and scan credentialing/re-credentialing files and other credentialing documentation into scanning software
Community Outreach Liaison:
- Supporting the mission, vision, and core values of the organization.
- Manages and coordinates outreach events and other requests for organizations, businesses, and municipalities in order to attract patients
- Markets and promotes services and programs through lunch & learn presentations, webinar meetings on a scheduled basis
- Strengthens existing relationships and cultivates new ones through working with existing physicians and new referring physicians alike
- Strategically reaches out to facilities for care coordinator placement, various referrals (e.g., swing bed), and other marketing opportunities
- Coordinate professional presentations to community groups on referral topics
- Maintain the established business plan in regards to the development of relationships and contacts, resulting in increased marketing, referrals, and overall community involvement
- Attend meetings, Chamber, Rotary, community organizations for the purpose of developing a presence in the community and serving as a liaison between external stakeholders and CCH
- Collaborates with internal and external stakeholders for the purpose of building effective communication, enhancing relationships, and ensuring a high quality of customer service to achieve hospital goals and objectives
- Perform as a navigator for the patient in coordinating hospital resources, community resources and any other applicable resources for the patient care after CCH discharge.
- Maintains knowledge in industry trends and current competency in specialty by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
- Functions as a contributing team member & communicates effectively with all levels of people.
- Promotes positive public relations to physicians, patients, visitors, other employees, and the community.
- Participates in performance improvement activities.
- Provides for patients’/significant others’ rights and safety; strives to manage situations in a manner to reduce risk while following legal and regulatory standards.
- Performs other tasks and duties as assigned in an efficient, effective and cost-conscious manner, complying with all hospital policies, procedures, and regulations.
KNOWLEDGE, SKILLS, QUALIFICATION and EDUCATIONAL AND /OR EXPERIENCE REQUIREMENTS:
- Minimum of 3 years experience in healthcare, marketing, communications or public relations with
demonstrated success, preferably in the not-for-profit or association sector
- Bachelor’s degree in journalism, marketing, public relations, or related healthcare field preferred – Associate’s Degree required
- Commitment to working with shared leadership and in cross-functional teams
- Strong oral, written communications, Critical thinking, and multitasking skills
- Ability to:
- manage multiple projects at a time
- maintain complete and accurate records and statistics and to develop meaningful reports from that information.
- effectively express ideas orally and in writing.
- make oral presentations before large/small groups of people.
- exercise considerable tact and courtesy in frequent contact with the public.
- establish and maintain effective working relationships as necessitated by work assignments.
- maintain HIPAA & confidential information
- Interpersonal skills necessary in order to communicate effectively with physicians, stakeholders, and other hospital personnel often requiring exceptional courtesy and tact
- Ability to read, write, and follow written and verbal instructions independently.
- Knowledge of Microsoft Office and other management software and knowledge of electronic systems and equipment
PHYSICAL DEMANDS / WORKING CONDITIONS:
May be exposed to patient elements, prolonged, extensive or considerable standing/walking, sitting, bending/twisting, kneeling/squatting, reaching, climbing and should be able to lift 25 or more pounds using proper lifting techniques. Rapidly changing and stressful environment. Ability to communicate with various levels of people. Possible exposure to communicable and infectious disease and hazardous materials. Occasional exposure to unpleasant patient or unit elements (accidents, injuries and illness). Contact with patients under a wide variety of circumstances. Subject to varying and unpredictable situations. Handles emergency or crisis situations. Subject to many interruptions. Occasional pressure due to multiple tasks and inquiries.
The information in this job description is intended to describe the general nature and level of work being performed by people assigned to this classification and requirements for the performance of this job.
They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
CCH is an equal opportunity employer and drug free work place.