Under the direction of the Manager, Medical Staff Affairs responsible for the coordination of all activities and data management related to the credentialing and privileging of physicians, licensed independent and licensed dependent providers in accordance with bylaws, federal, state and accreditation guidelines. Performs complex and diversified administrative functions. Must be able to meet deadlines, work on several projects at once, and understand all of the concepts involved in the work performed. Require some independent judgments. Provide work flow oversight and assist with the training and assignment of work to members of the work unit.
Maintain medical staff operational compliance with Bylaws, Joint Commission, and Department of Health and Accreditation standards.
Conduct audits of credentialing and privileging documents and files.
Interface with division administrators regarding status of documents and files.
Communicate and support medical staff teams and committees.
Develop collection and distribution cycle for medical staff committees.
Coordinate initial credentialing and recredentialing such as querying NPDB, verification of license, certifications, expired credentials and competency standing.
Process initial and credentialing files.
Provide workflow oversight and train team members.
Coordinate, prioritize and facilitate team workflow to ensure efficient delivery of service.
Train, assign and supervise staff work assignments.
Maintain access codes for online verification entities.
Ensure timely verification of provider competency and credentials.
Ensure the processing of appointment notification and medical staff invoices.
Maintenance of Files, Credentialing and Privileging Database
Ensures credentialing and privileging database is timely and accurately maintained.
Process data request from internal and external customers.
Ensures the collection, scanning, storage, filing and retrieval of credentialing and privileging documents.
Maintain department documents and electronic share drive.
Maintain superior customer service.
Prioritize customers concerns and follow up within 24 hours on all queries.
Communicate weekly with division administrators and provide reports.
Coordinate request from CHOPPA groups.
Use independent judgment and problem solving.
Distribute written correspondence and other written materials to the appropriate person.
Coordinate team projects in a collaborative manner.
Accept project request and determine staff assignment.
Maintain organized documentation of current and outstanding projects within the shared database.
Coordinate internal and external partner audits.
Required Licenses, Certifications, Registrations
CPCS or CPMSM (within 1 year)
Required Education and Experience
Required Education: Associates degree.
Required Experience: Five or more years of credentialing and privileging experience within a hospital setting. Demonstrate working knowledge of Joint Commission, NCQA, Department of Health Credentialing and Privileging standards.
Preferred Education, Experience & Cert/Lic
Additional Technical Requirements
Proficient in Microsoft Word, Excel, PowerPoint and Access.
Experience with credentialing database software preferred.
Ability to handle multiple tasks and projects simultaneously.
Strong organizational and follow-up skills.
Ability to handle confidential materials and matters.
Excellent communication skills
Strong writing and reading aptitude.
All CHOP employees who work in a patient building or who provide patient care are required to receive an annual influenza vaccine unless they are granted a medical or religious exemption.
Children's Hospital of Philadelphia is committed to providing a safe and healthy environment for its patients, family members, visitors and employees. In an effort to achieve this goal, employment at Children's Hospital of Philadelphia, other than for positions with regularly scheduled hours in New Jersey, is contingent upon an attestation that the job applicant does not use tobacco products or nicotine in any form and a negative nicotine screen (the latter occurs after a job offer).
Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability or protected veteran status.
VEVRAA Federal Contractor/Seeking priority referrals for protected veterans. Please contact our hiring official with any referrals or questions. CHOP Careers Contact : Talent Acquisition Address: 3401 Civic Center Blvd. Philadelphia, PA 19104 Phone: 866-820-9288 Email: TalentAcquisition@email.chop.edu
Since its start in 1855 as the nation's first hospital devoted exclusively to caring for children, Children's Hospital of Philadelphia has been the birthplace for many dramatic firsts in pediatric medicine. The Hospital has fostered medical discoveries and innovations that have improved pediatric healthcare and saved countless children’s lives.
Today, Children's Hospital of Philadelphia is one ...of the leading pediatric hospitals and research facilities in the world. Our 150 years of innovation and service to our patients, their families and our community reflect an ongoing commitment to exceptional patient care, training new generations of pediatric healthcare providers and pioneering significant research initiatives.