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*Description*

*Purpose*: Responsible for ensuring the timely and efficient credentialing, including initial

appointment, reappointment and privileging of all new and standing medical staff members

in order to be in compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS,

federal and state), as well as the Medical Staff Bylaws, Rules and Regulations, policies and

procedures and delegated contracts.

*Essential Responsibilities:*

1. Prepares, disseminates, collects, reviews and processes applications for appointment

and reappointment, and accompanying documents, ensuring applicant eligibility.

2. Conducts thorough background investigation, research and primary source

verification of all components of the application file, including retrieval of National

Practitioner Database Reports in accordance with the Health Care Quality Act.

3. Identifies issues that require additional investigation and evaluation, validates

discrepancies and ensures appropriate follow-up and closure.

4. Prepares and completes credential files for review by the appropriate department

chair and presentation at relevant Medical Staff Committees, ensuring file completion

within time periods specified.

5. Reviews and processes request for change in privileges, ensuring compliance with

the Medical Staff Bylaws, Credentials Policy, and criteria outlined in clinical privilege

descriptions.

6. Reviews and processes requests for change in staff status, ensuring compliance with

the Medical Staff Bylaws and Credentials Policy

7. Responds to inquiries from other healthcare organizations, interfaces with internal

and external customers on day-to-day credentialing and privileging issue as they aris

and assists with credentialing audits by internal and external surveyors

8. Utilizes the credentialing database, optimizing efficiency, and performs data entry,

query, report and document generation.

9. Adheres to the credentialing and privileging process for assigned medical staff

members, ensuring compliance with regulatory bodies (Joint Commission, NCQA,

URAC, CMS, federal and state), as well as the Medical Staff Bylaws, Rules and

Regulations, policies and procedures and delegated contracts.

10. Collects appointment and reappointment application fees, annual medical staff dues

and reappointment fines

11. Creates, updates, and disseminates to relevant individuals within the organization,

detailed reports on credentialing activities

12. Maintains and Models Nuvance Health Values.

13. Demonstrates regular, reliable and predictable attendance.

14. Performs other duties as required.

*Education and Experience Requirements:*

- Minimum three (3) years’ experience in credentialing or equivalent

experience preferred

- Associates degree preferred

Minimum Knowledge, Skills and Abilities Requirements:

- Proficiency in the use of credentialing databases and MS Word, Excel and

Outlook. Ability to: communicate effectively, both orally and in writing; work

effectively in a team environment; plan, prioritize and work multiple actives

and tasks effectively, to produce work in high quantity and quality; to

analyze, interpret and draw inferences from research findings and to prepare

reports; to use independent judgment to manage and impart confidential

information. Must have knowledge of related accreditation and certification

requirements, to have knowledge of medical credentialing and privileging

procedures and standards, working knowledge of clinical and /or hospital

operations and procedures, database entry and management skills including

querying, reporting and document generation.

*License, Registration, or Certification Requirements:*

- Certified Provider Credentialing Specialist after 3 years on the job

experience

*Working Conditions:*

Manual: Little or no manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Northern Dutchess Hospital

Org Unit: 1843

Department: Credentialing

Exempt: No

Salary Range: $20.86 - $38.73 Hourly

We are an equal opportunity employer

Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation or our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to ensure that you are considered for current or future opportunities.