Hoag Memorial Hospital Presbyterian
Enterprise Credentialing Specialist : Enterprise Credentialing - Full Time - 08H
Hoag Memorial Hospital Presbyterian, Newport Beach, California, us, 92659
Job Description
The Enterprise Credentialing Specialist maintains regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations. The Enterprise Credentialing Specialist creates and carries out various credentialing processes in relation to physicians, various other healthcare professionals and sites. The Enterprise Credentialing Specialist assists the Supervisor in ensuring that all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws.
The Enterprise Credentialing Specialist generally processes applications and reappointment paperwork, checking for full completeness and accuracy. The Enterprise Credentialing Specialist constantly collects and processes significant amounts of verification and accreditation information, and thus must constantly maintain and update accurate databases for both practitioners and facilities. These databases include pertinent education, training, experience, and licensure content. The Enterprise Credentialing Specialist must prepare their own records for regular auditing, as well as maintain close communication with all appropriate practitioners to ensure that records are up-to-date and consistent.
It Is expected that the employee holding this position will demonstrate behaviors consistent with our core values and will comply with all required standards.
Qualifications
Education and Experience
High School diploma, GED, California High Proficiency or equivalent work experience
Proficiency with Microsoft Office Products (Word, Excel, PowerPoint)
Experience specific to NCQA standards preferred
Certifications Preferred
Certified Professional Credentialing Analyst (CPCS)
Certified Professional Medical Services Professional (CPMSM)
About Us
Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.
For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County's health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.
Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.
Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.
To learn more about Hoag's awards and accreditations, https://www.hoag.org/about-hoag/awards-accreditations/.
Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.
The Enterprise Credentialing Specialist maintains regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations. The Enterprise Credentialing Specialist creates and carries out various credentialing processes in relation to physicians, various other healthcare professionals and sites. The Enterprise Credentialing Specialist assists the Supervisor in ensuring that all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws.
The Enterprise Credentialing Specialist generally processes applications and reappointment paperwork, checking for full completeness and accuracy. The Enterprise Credentialing Specialist constantly collects and processes significant amounts of verification and accreditation information, and thus must constantly maintain and update accurate databases for both practitioners and facilities. These databases include pertinent education, training, experience, and licensure content. The Enterprise Credentialing Specialist must prepare their own records for regular auditing, as well as maintain close communication with all appropriate practitioners to ensure that records are up-to-date and consistent.
It Is expected that the employee holding this position will demonstrate behaviors consistent with our core values and will comply with all required standards.
Qualifications
Education and Experience
High School diploma, GED, California High Proficiency or equivalent work experience
Proficiency with Microsoft Office Products (Word, Excel, PowerPoint)
Experience specific to NCQA standards preferred
Certifications Preferred
Certified Professional Credentialing Analyst (CPCS)
Certified Professional Medical Services Professional (CPMSM)
About Us
Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.
For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County's health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.
Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.
Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.
To learn more about Hoag's awards and accreditations, https://www.hoag.org/about-hoag/awards-accreditations/.
Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.