Credentialing Team Lead

General Description:

Provides guidance and technical support to and oversight of the medical staff credentialing functions related to the reappointment process.

Essential Responsibilities:

Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.

• Provides oversight of the medical staff credentialing process for reappointment, as well as implementation of applicable policies and procedures, to ensure timely verification and completion of reappointment applications.
• Serves as a liaison between the credentialing coordinators processing reappointments and the manager of the credentialing process.
• Plans, organizes, assigns, and oversees the day-to-day operations and facilitates the workflow of the reappointment processes to ensure deadlines are met.
• Works with the reappointment team staff on the daily operations of the reappointment functions to monitor processes and procedures related to reappointments and to ensure excellent service to the medical staff.
• Ensures equitable distribution of work assignments pertaining to the reappointment process to the Credentialing Coordinators under the direction of the Medical Staff Services Department Director.
• Ensures and completely understands downstream/organization impacts are identified, understood, and communicated. Develops/improves/documents and implements medical staff processes/procedures specific to the reappointment process workflows, from initial launch of reappointments to notification of the final recommendation by the Board.
• Provides input to the Credentialing Manager and Medical Staff Services Director regarding staff performance, objectives being met, i.e., turnaround times, KPIs, or any problems related to the reappointment credentialing team.
• Performs the functions of the Credentialing Coordinator which includes the processing of reappointment applications as well as the maintenance of medical staff databases, as needed.
• Assists with the development of medical staff policies and forms related to the reappointment process.
• Identify trends or issues, rectifies when appropriate and alert management to concerns.
• Develops improved processes in coordination with Credentialing Manager and Director to increase efficiency of team.
• Remains the subject matter expert pertaining to the reappointment process.

General Responsibilities:

• Performs other duties as assigned.

Minimum Qualifications:

Education: Associate degree in related field of study. Bachelor's Degree preferred.

Experience: Three (3) years credentialing experience.

License(s)/Certification(s)/Registration(s) Required:

NAMSS certification as a Certified Provider Credentialing Specialist (CPCS) is strongly preferred or achievement of certification (CPCS) within 24 months of becoming eligible.

Knowledge, Skills, and Abilities:

Knowledge of CMS Regulatory, Joint Commission, and NCQA accreditation standards and legal requirements related to medical staff organization and credentialing. Knowledge of relevant laws and regulatory standards. Ability to establish and maintain effective customer relationships. Excellent verbal and written communication skills. Medical Staff software knowledge and utilization. Ability to work effectively in a team environment. Team leadership skills.