Job Description
Coordinates and organizes credentialing/privileging requests/modifications for an SHC facility and supports providers requesting privileges at affiliate locations. Ensures evidence of education, training, and experience to determine eligibility for requested privileges, membership. Verifies and documents credentials and expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards and manages and documents all communication with providers and primary facilities to ensure notification of upcoming expirables. Keeps record of all credentialing activities in the credentialing database to ensure files reflect current status. Recognizes, investigates, and validates discrepancies and adverse information obtained and obtains and evaluates practitioner sanctions, complaints, and adverse data to ensure compliance. Responsible for confidentiality and data entry, maintenance, and analysis of clinical provider information within database per established guidelines to ensure complete electronic credential file to support provider enrollment and delegation requirements. Collaborates credentialing, OPPE, FPPE and privileging activities with SHC Medical Staff Offices to ensure timely approval process of governing bodies, participation in accreditation surveys and audits, to include verification of appropriate drug and criminal background screenings. Prioritizes workload to meet deadlines. Maintains current knowledge of accreditation standards (TJC, NCQA), state and federal regulations, as well as SHC medical staff bylaws, regulations, and procedural rules.
About Shriners Children’s
Shriners Children’s is an organization that respects, supports, and values each other and is engaged in providing excellence in patient care.