Hoag Health System
Supervisor Enterprise Credentialing : Enterprise Credentialing - Full Time - 08H
Hoag Health System, Newport Beach, California, us, 92659
Overview
Supervisor Enterprise Credentialing: Enterprise Credentialing - Full Time - 08HR - Hoag Newport Beach Role: Under the direction of the Executive Director of Enterprise Medical Staff Services and Credentialing (EMSSC), the Supervisor leads, coordinates, monitors, and maintains credentialing and privileging processes and related functions. Ensures interpretation and compliance with accrediting and regulatory agencies, maintains knowledge of NCQA standards, and ensures timely credentialing and privileging activities in accordance with bylaws, policies, procedures, and external accreditation standards, state laws, and Medicare Conditions of Participation. Primary Duties and Responsibilities
Lead, coordinate, monitor, and maintain credentialing and privileging processes and related functions. Ensure interpretation and compliance with accrediting and regulatory agencies. Develop and maintain knowledge of statutes and laws relating to NCQA standards. Coordinate functions required to conduct credentialing and privileging for the medical staff organization, ensuring activities are timely and compliant with internal and external requirements. Oversee process supervision, application management, credential verification, file maintenance (electronic), expirables management, information management, focused review, and support for evaluation and decision-making. Assist in developing reports for submission to healthcare plans and other regulatory and accrediting bodies. Qualifications
Education and Experience
High School diploma, GED, California High Proficiency or equivalent work experience Proficiency with Microsoft Office products (Word, Excel, PowerPoint) Experience with NCQA standards Credentialing database management Preferred
2 years of lead or supervisory experience in Medical Staff/Credentialing Services in an acute care setting Associate’s Degree in a healthcare management related major 1+ years of experience with MD Staff, including use of MD-App 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, a network of more than 1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. Hoag offers a comprehensive blend of health care services and is recognized for awards and accreditations. Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to equal employment opportunity and providing a work environment free of discrimination.
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Supervisor Enterprise Credentialing: Enterprise Credentialing - Full Time - 08HR - Hoag Newport Beach Role: Under the direction of the Executive Director of Enterprise Medical Staff Services and Credentialing (EMSSC), the Supervisor leads, coordinates, monitors, and maintains credentialing and privileging processes and related functions. Ensures interpretation and compliance with accrediting and regulatory agencies, maintains knowledge of NCQA standards, and ensures timely credentialing and privileging activities in accordance with bylaws, policies, procedures, and external accreditation standards, state laws, and Medicare Conditions of Participation. Primary Duties and Responsibilities
Lead, coordinate, monitor, and maintain credentialing and privileging processes and related functions. Ensure interpretation and compliance with accrediting and regulatory agencies. Develop and maintain knowledge of statutes and laws relating to NCQA standards. Coordinate functions required to conduct credentialing and privileging for the medical staff organization, ensuring activities are timely and compliant with internal and external requirements. Oversee process supervision, application management, credential verification, file maintenance (electronic), expirables management, information management, focused review, and support for evaluation and decision-making. Assist in developing reports for submission to healthcare plans and other regulatory and accrediting bodies. Qualifications
Education and Experience
High School diploma, GED, California High Proficiency or equivalent work experience Proficiency with Microsoft Office products (Word, Excel, PowerPoint) Experience with NCQA standards Credentialing database management Preferred
2 years of lead or supervisory experience in Medical Staff/Credentialing Services in an acute care setting Associate’s Degree in a healthcare management related major 1+ years of experience with MD Staff, including use of MD-App 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, a network of more than 1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. Hoag offers a comprehensive blend of health care services and is recognized for awards and accreditations. Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to equal employment opportunity and providing a work environment free of discrimination.
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