Credentialing & Privileging Specialist

ESSENTIAL ROLES & RESPONSIBILITIES:

• Manage and facilitate credentialing/privileging efforts for the organization.
• Interact with candidates to facilitate data retrieval and conduct primary source verifications.
• Participate in strategy development and implementation process improvement.
• Manage day to day activities to include the following:
  • Privilege medical staff in conjunction with an evaluation of the individual's clinical qualifications and/or performance.
  • Credential medical staff based on academic preparation, licensing, training, certifications, and performance.
  • Direct communication with healthcare practitioners, contract service manager, and supervision.
  • Receive and starts credentialing process for assigned providers.
  • Obtain required documentation to meet the minimum credentials prior to the provider beginning his/her assignment.
  • Identify possible red flags and work with risk to assess and approve during the credentialing process.
  • Maintain credentialing files, logs, and data required to ensure continued credentialing.
  • Communicate with clinical staff to ensure licenses, certifications, and provider privileges remain current.
  • Prepare for and attends weekly meetings to provide physician coordinators updates to other internal teams (clinical coordinators, project managers, recruiters, contract service manager).
  • Continue to grow knowledge and understanding of telemedicine rules and regulations as they relate to privileging and ability to deliver clinical services.
• Assemble and maintain statistical data, including maintaining licensing, records, vaccines, etc.
• Establish and maintain effective working relationships with clients and clinical staff.
• Communicate relevant information to all stakeholders in a timely manner.
• Update credentialing database as needed.
• Perform clerical and administrative tasks as needed.
• Perform and oversee specific projects and programs as assigned.

QUALIFICATIONS - EDUCATION, WORK EXPERIENCE, CERTIFICATIONS:

• Bachelor's degree preferred and/or relevant work experience.
• Proficient Knowledge of Microsoft Word, Excel, and Outlook.
• Credentialing systems knowledge strongly preferred.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Project management skills and well organized.
• Outstanding interpersonal skills including the ability to communicate effectively with persons throughout an organization, including clinicians.
• Able to assist team members as needed and demonstrate strong teamwork skills
• Excellent verbal and written communication skills.
• Strong attention to detail skills and organizations skills.
• Knowledge of the process and tools for capturing, organizing, and using individual and departmental intellectual assets, such as competencies, best practices, etc.

Overview

Jackson Healthcare Government Services is an innovator in the delivery of healthcare workforce solutions across the nation, leading the way as a comprehensive healthcare professional and support staffing, technology and program management partner to federal, state and municipal government agencies of all types and sizes.

EEO Statement

Jackson Healthcare is an EEO/AA Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender, gender identity and expression, national origin, age, disability or protected veteran status. We celebrate diversity and are committed to creating an inclusive environment for all of our associates.