MPF Credentialing SpecialistSan Diego, California
In accordance with The Joint Commission, State, Medical Staff, Hospital Standards, and legal requirements, obtains, verifies and analyzes all information on medical staff applicants for membership and privileges, and for reappointment. Facilitates review by medical staff and hospital leadership. Facilitates review and approval of Ongoing Professional Practice Evaluation for practitioners with privileges. Interfaces with medical staff officers and leaders, hospital leadership and chairs of supported hospital and medical staff committees and departments to ensure that issues requiring action are reviewed in a timely manner and results are documented and disseminated to the appropriate parties for further review/action, information, education, and/or completion. Schedules and supports medical staff committee and department meetings as assigned. Oversees the completion and adequacy of proctoring and privileging, and ensures that physician privileges granted are based on adequate documentation of background and training, experience, and current clinical competence.
RCSSD: In accordance with NCQA standards, obtains, verifies and analyzes provider information for health plan credentialing. Submits applications to health plans and monitors for re-credentialing.
High School Diploma
3 years of experience
4 years of experience