NCH
DEPARTMENT:
18400 - Medical Staff LOCATION:
350 7th Street North, Naples, FL, 34102 WORK TYPE:
Full Time WORK SCHEDULE:
8 Hour Day
ABOUT NCH
NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
NCH is transforming into an Advanced Community Healthcare System(TM) and we're proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH - for you and every person we serve together. Visit nchjobs.org to learn more.
JOB SUMMARY
The Coordinator Onboarding & Compliance in Medical Staff Services is responsible for overseeing the onboarding process for new physicians and advanced practice providers (APPs), ensuring a seamless transition into the organization. This role ensures compliance with all regulatory requirements by conducting payer delegation audits, credentialing delegation agreement audits, internal credential file audits, and regulatory reporting. The coordinator will work closely with various departments to ensure adherence to hospital policies, accreditation standards, and payer requirements.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Other duties may be assigned.
Onboarding of New Physicians and Advanced Practice Providers (APPs): • Coordinate and manage the end-to-end onboarding process for new medical staff, including physicians and APPs. • Serve as the primary point of contact for new providers, guiding them through credentialing, orientation, and training requirements. • Facilitate communication between new providers and key departments (e.g., Human Resources, IT, Clinical Operations) to ensure a smooth onboarding experience. • Track and manage completion of onboarding checklists, required documentation, and training modules. • Ensure compliance with hospital policies, regulatory standards, and accreditation requirements during the onboarding process.
Payer Delegation Audits: • Conduct audits of delegated credentialing agreements with payers to ensure compliance with contractual and regulatory requirements. • Prepare for and participate in payer delegation audits, responding to audit findings and implementing corrective actions as needed. • Collaborate with internal stakeholders to maintain accurate records for payer audits and ongoing compliance. • Monitor changes in payer requirements and update internal processes accordingly.
Regulatory Reporting: • Ensure timely and accurate submission of required regulatory reports related to medical staff services (e.g., National Practitioner Data Bank, state licensing boards, accreditation bodies). • Stay current with healthcare regulations and accreditation standards (e.g., Joint Commission, NCQA, CMS) and incorporate changes into compliance processes. • Assist in the preparation of compliance reports and presentations for leadership and regulatory agencies.
Credentialing Delegation Agreement Audits: • Perform periodic audits of credentialing delegation agreements to ensure compliance with contracted entities and regulatory agencies. • Identify areas of risk and recommend process improvements to maintain compliance. • Coordinate with credentialing staff to implement corrective actions and process enhancements.
Internal Credential File Auditing: • Conduct regular internal audits of credentialing files to ensure completeness, accuracy, and compliance with organizational and regulatory standards. • Identify and address gaps in credentialing documentation, implementing corrective measures as necessary. • Develop and maintain audit tracking tools to ensure ongoing compliance monitoring. • Provide reports and recommendations to leadership based on audit findings.
EDUCATION, EXPERIENCE AND QUALIFICATIONS • Bachelor's degree in healthcare administration, business administration, or a related field required OR Associate's degree with 6 years of equivalent work experience in lieu of Bachelor's degree. • Minimum of 3 years of experience in medical staff services, credentialing, or healthcare-related field. • Certified Provider Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist (CPES) preferred. • Excellent organizational and project management skills with the ability to handle multiple priorities. • Strong attention to detail and accuracy in documentation and reporting. • Proficient in credentialing software (e.g., MDStaff) and Microsoft Office Suite (Word, Excel, Outlook). • Strong interpersonal and communication skills to effectively collaborate with internal and external stakeholders. • Ability to analyze data and provide meaningful insights and recommendations.
18400 - Medical Staff LOCATION:
350 7th Street North, Naples, FL, 34102 WORK TYPE:
Full Time WORK SCHEDULE:
8 Hour Day
ABOUT NCH
NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
NCH is transforming into an Advanced Community Healthcare System(TM) and we're proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH - for you and every person we serve together. Visit nchjobs.org to learn more.
JOB SUMMARY
The Coordinator Onboarding & Compliance in Medical Staff Services is responsible for overseeing the onboarding process for new physicians and advanced practice providers (APPs), ensuring a seamless transition into the organization. This role ensures compliance with all regulatory requirements by conducting payer delegation audits, credentialing delegation agreement audits, internal credential file audits, and regulatory reporting. The coordinator will work closely with various departments to ensure adherence to hospital policies, accreditation standards, and payer requirements.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Other duties may be assigned.
Onboarding of New Physicians and Advanced Practice Providers (APPs): • Coordinate and manage the end-to-end onboarding process for new medical staff, including physicians and APPs. • Serve as the primary point of contact for new providers, guiding them through credentialing, orientation, and training requirements. • Facilitate communication between new providers and key departments (e.g., Human Resources, IT, Clinical Operations) to ensure a smooth onboarding experience. • Track and manage completion of onboarding checklists, required documentation, and training modules. • Ensure compliance with hospital policies, regulatory standards, and accreditation requirements during the onboarding process.
Payer Delegation Audits: • Conduct audits of delegated credentialing agreements with payers to ensure compliance with contractual and regulatory requirements. • Prepare for and participate in payer delegation audits, responding to audit findings and implementing corrective actions as needed. • Collaborate with internal stakeholders to maintain accurate records for payer audits and ongoing compliance. • Monitor changes in payer requirements and update internal processes accordingly.
Regulatory Reporting: • Ensure timely and accurate submission of required regulatory reports related to medical staff services (e.g., National Practitioner Data Bank, state licensing boards, accreditation bodies). • Stay current with healthcare regulations and accreditation standards (e.g., Joint Commission, NCQA, CMS) and incorporate changes into compliance processes. • Assist in the preparation of compliance reports and presentations for leadership and regulatory agencies.
Credentialing Delegation Agreement Audits: • Perform periodic audits of credentialing delegation agreements to ensure compliance with contracted entities and regulatory agencies. • Identify areas of risk and recommend process improvements to maintain compliance. • Coordinate with credentialing staff to implement corrective actions and process enhancements.
Internal Credential File Auditing: • Conduct regular internal audits of credentialing files to ensure completeness, accuracy, and compliance with organizational and regulatory standards. • Identify and address gaps in credentialing documentation, implementing corrective measures as necessary. • Develop and maintain audit tracking tools to ensure ongoing compliance monitoring. • Provide reports and recommendations to leadership based on audit findings.
EDUCATION, EXPERIENCE AND QUALIFICATIONS • Bachelor's degree in healthcare administration, business administration, or a related field required OR Associate's degree with 6 years of equivalent work experience in lieu of Bachelor's degree. • Minimum of 3 years of experience in medical staff services, credentialing, or healthcare-related field. • Certified Provider Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist (CPES) preferred. • Excellent organizational and project management skills with the ability to handle multiple priorities. • Strong attention to detail and accuracy in documentation and reporting. • Proficient in credentialing software (e.g., MDStaff) and Microsoft Office Suite (Word, Excel, Outlook). • Strong interpersonal and communication skills to effectively collaborate with internal and external stakeholders. • Ability to analyze data and provide meaningful insights and recommendations.