Credentialing Specialist - Medical Staff Affairs

Responsible for the coordination and oversight of the hospital Medical Staff Affairs office, including collaboration with the Central Verification Organization (CVO) on medical staff credentialing and recredentialing processes. Coordinates and manages medical staff meetings and communication flow from Medical Staff Committees through the Medical Executive Committee to the Board of Trustees. Responds to verification requests and acts as a resource to the medical staff regarding bylaws, regulations, policies, and accreditation standards.

Assists in compliance with accrediting agencies such as the Joint Commission, NCQA, URAC, and HFAP, developing knowledge of relevant statutes and laws. Coordinates annual projects related to the medical staff and manages related administrative activities. Maintains communication with physician quality teams, medical staff leaders, hospital administration, and legal counsel on medical staff issues. Ensures confidentiality of all medical and business information and works as part of a team to optimize departmental performance.

• Interprets, explains, and ensures adherence to all regulatory guidelines, including medical staff bylaws, rules, regulations, and policies.
• Manages credentialing processes for initial and reappointment applications, ensuring compliance with standards and deadlines.

High School Diploma required;
Associate's Degree preferred. At least one (1) year of experience in credentialing, provider enrollment, or background/verification is required. Must have a high level of energy to work efficiently in a fast-paced environment with deadlines, interruptions, and multiple demands. Working knowledge of state and federal laws related to due process and HIPAA, as well as applicable standards, is required.

• Organization:
  Henry Ford Jackson Hospital
• Department:
  Medical Staff Credentialing Services
• Shift: Day Job
• Union Code:
  Not Applicable