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When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Position Summary: The BID-Needham Credentialing Specialist performs assigned functions necessary to ensure all new and reappointed Medical Staff are credentialed according to the guidelines established by the Medical Staff Bylaws, the Joint Commission, and State and Federal regulatory agencies.

Exemplifies a culture of excellence, effective communication and collaboration, and customer service with hospital and CVO leadership and staff, internal and external customers, providers, and clinical and administrative leaders within BILH.

Handles, with discretion, issues that are significant, complex, multidisciplinary, sensitive, and confidential.

Possesses and/or develops a strong grasp of the medical staff operations.

Works to develop an overall singular culture of excellence and efficiency.

Job Description:

Essential Responsibilities:

+ Audit and analysis of credentials files received by the CVO for accuracy and completeness, to include identifying red flag and/or adverse information that requires further investigation.

+ Comply with required credential file turn-a-round times and adhere to established workflows.

+ Assist CVO, when needed, to follow-up with providers regarding late application submissions.

+ Timely follow-up on missing or incomplete information.

+ Timely and accurately prepare credential files for hospital leadership review and obtain the required approvals.

+ Effectively communicate, verbally and written, with all levels of leadership, providers, and staff who are involved in the credentialing process.

+ Participate in the monitoring of expiring information such as, federal and state DEA, state professional license(s), professional liability insurance, and specialty board certification status and obtain the required renewals, as assigned.

+ Update and maintain provider electronic credentialing records (i.e. timely, accurate, and complete database entries).

+ Assist in preparing for the Credentialing and Medical Executive Committee meeting to include, but not limited to agenda, meeting minutes, meeting materials and credential lists

+ Prepare and send initial and reappointment approval letters following Board of Trustees approval and within 30 days of Credentials Committee meeting.

+ Prepare and application request forms to the CVO, as assigned.

+ Process Temporary privileges, resignations, and category changes, as assigned.

+ Maintain a working knowledge of relevant regulatory standards (i.e., TJC and NCQA), state and federal requirements, and applicable Medical Staff Bylaws.

Required Qualifications:

+ High School diploma or GED required. Associate or Bachelor degree preferred.

+ At least one (1) year of experience in a CVO or Medical Staff Services Office in an acute healthcare setting that includes credentialing and privileging. 1-3 years of this same experience is preferred.

+ CPCS (Certified Provider Credentialing Specialist) preferred.

+ Strong oral, written communication skills and problem-solving skills.

+ Knowledge of credentialing software and associated applications strongly preferred.

+ Ability to work under minimal supervision and to adapt quickly to changes within the environment.

Competencies:

+ **Decision Making:** Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.

+ **Problem Solving:** Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.

+ **Independence of Action:** Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.

+ **Written Communications:** Ability to communicate clearly and effectively in written English with internal and external customers.

+ **Oral Communications:** Ability to comprehend and converse in English to communicate effectively with medical center staff, patients, families and external customers.

+ **Knowledge:** Ability to demonstrate full working knowledge of standard concepts, practices, procedures and policies with the ability to use them in varied situations.

+ **Team Work:** Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.

+ **Customer Service:** Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

Physical Nature of the Job:

Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

Pay Range:

$31.63 - $41.73

The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled