Credentialing Coordinator II

Are you looking to join a company based on excellence and love?

ChristianaCare is one of the country's most dynamic healthcare organizations, centered on improving health outcomes, making high-quality care more accessible, and lowering healthcare costs. ChristianaCare includes an extensive network of outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care, and women's health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation's Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. It is continually ranked by U.S. News & World Report as the Best Hospital. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

ChristianaCare Offers

• Full Medical, Dental, Vision, Life Insurance, etc.
• Two retirement planning offerings, including 403(b) with company contributions
• Generous paid time off with annual roll-over and opportunities to cash out
• 12-week paid parental leave
• Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial coaching, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

About this Position

ChristianaCare is searching for a Credentialing Coordinator II to be responsible for assigned medical staff to ensure that credentialing, privileging, and other important functions are performed in accordance with the Medical- Staff governance documents, CMS, The Joint Commission, NCQA and other rules as mandated by state and federal regulations. This includes obtaining, processing, maintaining, and reviewing the credentialing, privileging, and primary source verifications for ChristianaCare providers. The Credentialing Coordinator serves as a resource and collaborator with others in the Medical Staff Office, physician leaders and the Credentials Committee members.

PLEASE NOTE - This position works 100% in-office with no remote work capabilities. Please apply if you are looking to work in an office setting.

Principal duties and responsibilities:

Coordinates and verifies the accuracy of all credentialing/privileging functions for assigned departments to include the support of the department's credentials committee, agenda preparation, minute taking, and distribution and management of initial appointments and re-appointment applications.

Sends, reviews, and verifies preapplication and credentialing applications, if applicable. Uploads and maintains provider information in the credentialing database system.

Obtains and evaluates information from approved primary sources. Recognizes, investigates, and validates discrepancies and adverse information discovered during the credentialing process.

Complete background screening and state mandatory requirements for non-employed providers, as required. Tracks status of applications and maintains ongoing communication with provider throughout the credentialing and recredentialing process. Completes final file review to ensure complete file prior to department review.

Compiles, evaluates, and presents practitioner application (appointment and reappointment) for review by section leaders and Department Chairs.

Responds to external queries regarding provider status (hospital affiliation).

In collaboration with the Department Chairs and/or Section Chief, provides ongoing assessment and modification of privileging forms to ensure the consistency and standardization of the privileging processes. Manages change in privilege process for providers within assigned departments.

In collaboration with Manager and Corporate Director, coordinates and supports select committees of the medical staff (ad hoc and special committee meetings) to include the development of agendas and minute taking.

Follows the established departmental workflows and processes, including but not limited to waiver requests, license/board certification expiration, management of application for compliance with Medical Staff Bylaws and regulatory requirements.

Monitors expirable including but not limited to licensure for (state(s), CSR, DEA, board certification, life support and malpractice expirations. Communicates with providers when expiring document is due for renewal and follows through to ensure timely renewal and verification.

The Credentialing Coordinator II is expected to respond in a timely manner to all internal and external data requests. All departmental processes, as outlined in the ChristianaCare Credentials

Manual and governance documents, will be followed.

Familiarity with OPPE and FPPE processes to ensure processes are aligned with The Joint Commission and CMS Conditions of Participation.

Education and experience requirements:

• Associate's degree or equivalent required. Bachelor's degree in healthcare related field preferred. An equivalent combination of education and experience may be substituted.
• A minimum of two years' work-related experience is preferred. Prior experience in hospital credentialing/privileging processes preferred. Credentialing experience should include a combination of activity coordination and exposure to regulatory bodies such as The Joint Commission and CMS.
• Additionally, the Credentialing Coordinator II will be required to obtain certification as a Certified Provider Credentialing Specialist (CPCS) within 5 years of eligibility or within 1 year after reaching exam eligibility if new to ChristianaCare. This requirement is preferred if the candidate has been working as a Credentialing Specialist with greater than 15 years' experience in this profession.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visit https://careers.christianacare.org/benefits-compensation/