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Description
Job Schedule: Full Time
Standard Hours: 40
Job Shift: Shift 1
Shift Details:
Work where every moment matters.
Every day, almost 30,000 Hartford HealthCare employees come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network.
Hartford Hospital is one of the largest and most respected teaching hospitals New England. We are a Level 1 Trauma Center that provides cutting edge treatment to its patients. This is made possible by being home to the largest robotic surgery center in the Northeast and the Center for Education, Simulation and Innovation (CESI), one of the most-advanced medical simulation training centers in the world. When hospitals cannot provide the advanced care, expertise and new treatment options their patients require, they turn to us.
Job Summary:
Reporting to the Director/Manager of Medical Staff Services (MSS), performs functions of the medical staff Office. This includes credentialing and privileging functions related to the appointment/reappointment/clinical privileges of practitioners to the Medical Staff in accordance with HHC local Medical Staff Bylaws, Credentialing Policy and standards by The Joint Commission (TJC), Center for Medicare and Medicaid (CMS), and Connecticut Department of Public Health (DPH).
Job Responsibilities:
Function as a liaison for local medical staff leadership and administration, maintain knowledge of hospital bylaws, rules and regulations, policies and procedures, TJC, CMS, DPH and other state and federal regulatory requirements.
Carries out the Medical Staff initial application process. Evaluate and conduct quality review of each new application file once delivered from the CVO. Identify any outstanding verifications and red flag concerns. Recognize, investigate and validate discrepancies and adverse information obtained from the application, primary source verifications, or other sources. Prepare files for Credentials Committee Chair/Allied Health Chair review. Determine if applicants meet the qualifications and criteria for membership and/or clinical privileges. Notify Director/Manager of MSS, Department Chief, Medical Director, Credentials/Allied Health Committee as appropriate. Make recommendations of how issues and concerns may be addressed. Determine if applicants meet the requirements for temporary privileges and coordinate the approval process. Review applicants with Department Chief including any concerns and obtain Department Chief’s recommendation. Ensure that provider applications are processed through the Credentials, MEC and Board.
- Initiate onboarding process for Medical/Allied Health Staff with communication to applicable entities. Prepares bios for MEC.
- Processes Medical Staff reappointments and ensures that providers are reappointed within a two-year period. Recognize, investigate and validate discrepancies and adverse information obtained from the application, primary source verifications, or other sources. Determine if providers meet the qualifications and criteria for reappointment and clinical privileges. Flag areas of concern for Department Chief and prepare for Department Chief’s recommendation.
- Assure regulatory compliance of medical staff standards inclusive of TJC, State of CT, CMS, and hospital bylaws. Participate in the development of and make recommendations to standardize policies and procedures to support medical staff functions. Assists in preparation of hospital accreditation and licensure surveys.
- Responsible for oversight and/or verification of all expirables including: license, DEA, CSR, Malpractice, board certification and other certifications as needed and report concerns to practitioner, Department Chief/Manager, MSS.
- Assists with FPPE and OPPE process.
- Maintain the medical staff office and physicians’ credentials and peer review files in a confidential, organized, current, and retrievable manner.
- Update data in ECHO following Credentials/MEC/BOARD to reflect new/temporary privileges and resigned privileges. Responsible for the accuracy of the data.
- Coordinates the Credentials/Allied Health Committee.
Qualifications
- Associate’s degree and/or equivalent experience
- 2 years direct experience in hospital medical staff services or other credentialing or other credentialing or hospital administrative position.
- National Association Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) required. If not certified, obtain certification within 1 year of meeting the NAMSS eligibility requirements.
- Consistently demonstrates Hartford HealthCare’s Values: Integrity, Caring, Excellence, and Safety.
- Self-directed and self-motivational skills with a strong attention to detail.
- High level professional written and verbal communication skills. Mature attitude and judgment; responsible; professional demeanor and appearance, patient and flexible.
- Ability to manage multiple priorities and manage projects from initiation to completion within prescribed schedules and utilization of resources.
- Ability to analyze, interpret and draw inferences from research findings and present recommendations to medical staff leaders for credentialing and privileging issues, policies and bylaws.
- Ability to make administrative decisions and judgments using critical thinking skills.
- Working knowledge of medical terminology.
- The duties of this position include frequent professional level contact with physicians, health system executives, directors, and managers, and attorneys.
- Strong customer service skills.
- Knowledge of state, federal and Joint Commission medical staff standards and medical staff law
- Solid knowledge of Microsoft Office software applications; ability to master current and new software as needed.
- Solid knowledge of database management. Responsible for the accuracy and integrity of the credentialing database.
- Flexible schedule required to attend events/meetings in the early morning or in the evening to accommodate physician schedules.
- Ability to work well within a team.
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
