Credentialing Consultant

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Job Title:

Credentialing Consultant

Department:

University Hospital | Credentialing Services

Position Summary : The Delegated Credentialing Consultant leads, directs, monitors, and provides oversight and leadership to ensure operating efficiencies of the corporate credentialing services of the OSU hospitals, under the supervision of the Associate Director of Corporate Credentialing and/or Administrative Director. This position is responsible for management of operational activities related to the various functions that are required of the Corporate Credentialing Office and the CVO (Credentials Verification Organization) and for delegated credentialing requirements. This position is responsible for one or more of the specialty areas below:

• •Management of non-physician provider credentialing and privileging
• •Management of non-physician FPPE and OPPE processes
• •Management of delegated credentialing functions to include contracting, ongoing communication/liaison with MCO and OSUWMC Managed Care Contracting; provision of flat files in accordance with MCO contracts
• •Credentialing database management
• •Management of auditing of credentialing/recredentialing files in accordance with established guidelines, TJC standards, and NCQA requirements
• •Management of data entry/auditing of privileges into credentialing database for interface to CPD
• •Management of ongoing verification of licenses, DEA, board certifications, other licensing/regulatory requirements as mandated by law, regulation, accreditation standard, policy, or established standard
• •Management of tracking/auditing of graduate medical education trainee certificates; liaison with OSMB
• •Management of CAQH database on behalf of OSUWMC and tracking of new providers and assignment of OSUWMC Identification
• •Management of physician licensure application process; liaison with OSMB, FCVS, and FSMB

• Required Qualifications
• Bachelor's Level Degree or equivalent combination of education and experience. Bachelor degree in Medical Staff Sciences or equivalent courses, training and experience required. Strong supervisory, management, communication and writing skills. Minimum of five years of experience in hospital setting, preferably in the Medical Staff Services office. Intermediate computer knowledge. Familiarity with medical staff management software desired. Must be able to handle highly confidential information. Strong interpersonal and motivational skills. Certification as a Provider Credentialing Specialist preferred (CPCS) or Medical Staff Coordinator (CMSC). Masters degree preferred.

• Additional Education Desired
• Master's Degree or equivalent combination of education and experience

• FUNCTION: Health Care Administration
• SUB FUNCTION: Delegated Credentialing
• CAREER BAND: Individual Contributor - Specialized
• CAREER LEVEL: 4

Additional Information:

Location:

Ackerman Rd, 700 (0921)

Position Type:

Regular

Scheduled Hours:

40

Shift:

First Shift

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

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The university is an equal opportunity employer, including veterans and disability.