Employment Type:
Full time
Shift:
Day Shift
Description:
Serves as Lead Coordinator providing guidance and support to System Office staff responsible for providing physician credentialing support to the Regional Health Ministries (RHMs) including application processing and file auditing. Assist the Manager in managing daily operations within assigned functional area and ensuring alignment with established priorities and consistent completion of work assignments. Provides input in hiring decisions as well as colleague performance planning and review sessions. Performs a variety of credentialing tasks at the direction of CVO management to complete the credentialing process for Trinity Health RHMs. Provides education, training, and troubleshooting expertise on the various MSOW software modules.
This position is an integral part of the credentialing team and is responsible for following credentialing policies and procedures; maintaining an accurate physician data base; collecting data; and participating in development and implementation of changes to the credentialing processes.
ESSENTIAL FUNCTIONS
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
Identifies and schedules reappointment candidates.
Acts as primary liaison between assigned RHMs and their medical staff office leaders on routine file matters.
Serves as primary point person for credentialing inquiries from internal and external sources.
Functions as content expert on all assigned MSOW software modules, including the core database, the Practitioner Home Page, Privilege Inquiry, PSV, PCCB, ARM, and Apogee.
Performs file audits and provides feedback on completed initial and reappointment credentialing files.
Assists in the training and orientation of new team members.
Reviews colleague performance standards by performing quality assurance reviews on completed credentialing files, turnaround time standards, and other means to support CVO quality standards. Provides expedient feedback and works collaboratively with colleagues to improve performance. Assists management with establishing performance standards that drive and measure team performance.
Participates in the CVO team interview process as a team member evaluating potential colleagues and coordinates with the manager to provide the necessary training.
Assists as needed to provide on-the-job training, identification of colleague training needs and coordinates with the manager to provide the necessary training.
Collaborates with the colleague and management to conduct meaningful performance review, learning development plans and performance improvement plans when applicable. Provides input into the training and development for CVO colleagues to achieve superior performance through formal education, CVO competency reviews, classroom training, and on the job training.
Assists in the training and orientation of RHMs as they transition to the MSOW software platform.
Assists in daily data entry to ensure an accurate physician data base.
Communicates regularly with applicants and the RHMs to complete all requirements of the credentialing criteria within specified timeframes.
Contacts various primary sources to gather the required verifications to complete the background investigation via telephone, fax transmissions, mailings and Internet to ensure rapid completion of the application.
Prepares documentation of all verifications including a summary of all verified references for each completed credentials file.
Assists in the reappointment process; collecting required information, verifying information, and completing appropriate follow-up to complete the reappointment application.
Meets processing time thresholds consistently and with minimal error.
Maintains a customer-focus attitude, good rapport, and cooperative relationships. Approaches conflict in a constructive manner. Helps to identify problems, offer solutions, and participate in their resolution. Tracks errors and complaints to assist with process improvement activities.
Participates in professional development programs and professional organizations to grow in understanding of the various regulations and legislation of the health care industry as appropriate.
Maintains the confidentiality of information acquired pertaining to patient, physicians, employees, and visitors to Trinity Health. Discusses patient and hospital information only among appropriate personnel in appropriately private places.
Maintains the confidentiality of information acquired pertaining to patient, physicians, employees and visitors to Trinity Health. Discusses patient and hospital information only among appropriate personnel in appropriately private places.
Assumes responsibility for performance of job duties in the safest possible manner, to ensure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
Performs other duties as needed and assigned by the Director.
MINIMUM QUALIFICATIONS
Must possess a comprehensive knowledge of credentialing and privileging, as normally obtained through three years of post-high school education, training, or experience. Associates degree in health administration or a related field preferred.
Three to four years of work experience in the health care environment and general knowledge of the health care industry including hospital settings, physician practices, and managed care organizations.
Two to three years of experience as a lead coordinator, team leader, or equivalent supervisory experience.
Knowledge and understanding of NCQA and TJC standards, NPDB guidelines, hospital policies and procedures, and general licensing regulations.
Knowledge and experience with database organization and management, report generating languages, PC's and proficiency in Windows-based word processing software.
Current CPCS and/or CPMSM eligibility by the National Association Medical Staff Services. Certification required within one year of hire.
A strong desire and passion for working with teams of people, coaching and mentoring others to achieve team success. Must possess excellent teamwork skills and is comfortable giving and receiving direction, counsel and performance feedback.
Experience in driving customer satisfaction through proven, measurable results including an understanding of performance metrics and how they relate to team performance. Ability to identify areas of risk and also opportunities for creating efficiencies or improvements.
Strong communication skills including the ability to correspond effectively, as well as verbally convey information clearly, listen actively, and consider varying viewpoints when making decisions.
Strong statistical, analytical and problem-solving skills.
Ability and desire to provide quality service to others.
Ability to prioritize and coordinate completion of a number of activities/projects simultaneously.
Strong organizational skills and the ability to provide attention to detail and thoroughness.
Ability to work independently, prioritize and handle multiple responsibilities. A prudent self-starter, with motivation to produce high-quality output.
Ability to work autonomously and within a team environment.
Must be comfortable operating in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
**PHYSICAL AND
