Looking for a job in the state of Washington? See what opportunities are available below. Have a job that needs to be filled? Contact Shannon Rochon. Postings cost $35 per announcement ($50 for non-WAMSS members) and are active on the site for 30 days. Postings will be automatically removed after 30 days unless renewed for another month. Please let us know if you fill your position earlier so we can remove it from the page.
Proliance Surgeons Inc, Seattle, WA 98104
CREDENTIALING SPECIALIST – FT
The primary role of the credentialing specialist is to manage the daily workflow of credentialing and recredentialing applications with proficiency, accuracy and timeliness. This role participates in all aspects of initial credentialing, recredentialing and on-going monitoring for physicians and practitioners under established policies.
Essential Duties and Responsibilities:
- Maintain comprehensive knowledge of credentialing standards, primary source verification process and the accepted sources and methods required to obtain necessary documentation
- Work closely with the Chief Risk Officer to evaluate adequacy and information quality for effective and comprehensive peer review decision-making
- Maintain on-going Monitoring Program per NCQA and CMS standards
- Assist in annual review process for delegates to ensure timely credentialing pre-assessments, annual audits, file review, analysis, and written evaluation and ongoing follow up as applicable
- Maintain basic knowledge of credentialing delegation; requirements, oversight and industry standard
- Responsible for set up and maintenance of all credentialing files in an organized manner and closely monitor information collection and is cognizant of all information received and pursues additional information if necessary. Includes analyzing information per policy and NCQA & CMS standards
- Responsible for tracking the credentialing expiration elements of all facilities, physicians and practitioners with accuracy and timeliness
- Monitors system reporting for accuracy and assists in the maintenance of system identification for staggered credential renewals
- Works with other staff to streamline and improve processes related to credentialing and provider data
- Other job duties and projects as assigned
- Ability to critically analyze and apply standards to information submitted by the providers
- Ability to communicate effectively with providers, including sensitive and confidential information
- Must be able to prioritize and meet deadlines on an ongoing basis to ensure timely completion according to process requirements
- Detail oriented and highly accurate
- Demonstrates strong work ethic and maintains high expectation of individual work product
- Medical Terminology
- Proficiency in software applications to include data base integrity; and use of menu driven word processing and spreadsheet applications
- Experience with credentialing software is preferred, but not required
About Proliance Surgeons:
Proliance Surgeons is one of the largest surgical practices in the country, with over 425 providers including over 250 board-certified physicians providing treatment at more than 100 care centers in Washington State. Our range of specialties includes orthopedics, sports medicine, spine, ear nose & throat, general surgery, ophthalmology, obstetrics & gynecology, urology and more. Many of our surgeries are performed at our own outpatient surgery centers—where costs are often lower and recovery times faster than at a hospital. Patients return home the day of their surgery to begin healing and rehabilitation and get back to doing what they love, faster. Proliance physicians helped more than 650,000 patients last year alone and performed over 85,000 surgeries. Please review our website for more information www.proliancesurgeons.com for more information about our practice.
How to Apply:
If interested in applying, please email your cover letter and resume through the form below or email to firstname.lastname@example.org
Virginia Mason, Seattle, WA
DIRECTOR, MEDICAL STAFF SERVICES
Honored as Top Hospital of the Decade by The Leapfrog Group, Virginia Mason in Seattle, WA, is internationally recognized as a preeminent organization that is focused on transforming health care. True to that vision, we spent this past decade creating and delivering a multitude of innovations. The results? Industry-changing process improvements and initiatives that have revolutionized our ability to eliminate waste, cut costs, and most importantly, improve the quality of services. Our commitment to Team Medicine and the transformation of health care is what built our reputation as a quality leader and empowers us with the capability to provide rapid access to care through our Virginia Mason Production System.
As a key member of our leadership team, you will help to continually develop the results-driven initiatives that define our success and are transforming healthcare.
The Director of Medical Staff Services is a critical position for the organization and provides professional expertise and leadership to inform decision making, continuously improve processes, and ensure overall regulatory compliance related to credentialing, privileging, and medical staff governance. This position provides leadership, supervision, and expertise to a shared services model that supports credentialing functions for more than one hospital. This position provides an important contribution to our overall patient safety strategy and is highly regulated by The Joint Commission, CMS, and NCQA.
- Bachelor’s Degree required.
- Minimum 5 years progressive experience in a supervisory/leadership role in the medical staff services setting required.
- Certified Processional Medical Staff Services Management (CPMSM) required.
- Must possess a thorough understanding of medical staff credentialing and privileging regulatory requirements and best practices.
- Strong critical thinking skills.
- Strong written and verbal communication skills.
- Experience interacting with physicians in highly sensitive situations.
- Experience with electronic credentialing processes and shared services models supporting more than one facility.
- Must also have knowledge and skills with various credentialing software programs.
- Master’s degree preferred.
Virginia Mason, established in 1920 in Seattle, WA, is internationally recognized as a preeminent health care organization focused on delivering quality services to our patients. We have a 336-bed hospital in Seattle and multi-specialty medical group practice with more than 450 physicians. With a network of primary, specialty, neighborhood clinics and regional medical centers; you will find our culture is the very definition of best practices and a model that is the benchmark for other medical organizations. Join us and find out how many ways Virginia Mason offers you the chance to focus on what really matters—your patients.
Located in the Pacific NW, Seattle is an area with a mild climate year-round and close to the great outdoors where we enjoy an abundance of activities with our close proximity to the waters of Puget Sound and surrounding mountains. City life and cultural activities are also thriving. With a variety of neighborhoods and areas to work and live, there are many choices for the type of lifestyle you’d like to enjoy.
RADIA, Lynnwood, WA
Shift Details: Regular Full time, Clerical
Patients are our number one priority and we are committed to hiring staff who deliver excellence: in patient care, in customer service, in technology support and in operations. Radia is a place where you can make a real difference for our patients and for yourself.
Radia is currently seeking a Credentialing Specialist to join our credentialing team! The ideal candidate will be service oriented, have exceptional organizational skills and attention to detail.
The primary purpose of the credentialing specialist is to provide consistent, accurate, and timely credentialing support for the professional services corporation, which enhances the company’s ability to provide professional services to patients at multiple hospital and clinic locations
- Credentialing: Completes accurate and detailed professional applications for hospitals and/or payers. Follows for review and signature in a timely manner, with a goal of having applications completed within 120 day maximum timeline. Ensures that approval for hospital and payer privileges and effective dates are documented in detail.
- Interdepartmental Collaboration: Upholds a high level of understanding of credentialing and privileging and how it relates to other facets within (such as teleRadia, physician scheduling, quality and risk management) and outside of the organization. Recognizes opportunities for improving processes and can communicate effectively with physicians and hospital partners.
- License Renewals: Ensures that physician licenses are renewed prior to expiration 100% of the time. Documents payments and follows any outstanding items. Communicates completion to key customers.
- Primary Source Verification: Completes primary source verification as requested by management for new and existing physicians to ensure due diligence.
- Proctoring: Coordinates and documents proctoring process per hospital requests and internal needs based on current approved policy and guidelines.
- Continuing Medical Education: Works with team members to maintain current CME documentation for all medical professionals. Ensures that current information is provided to the clinical manager on a quarterly basis for MQSA accreditation and that totals yearly satisfy WA licensure requirements. Alerts physicians falling behind requirements.
- Records Management: Maintains assigned physician files, updating each item/action as processed. Utilizes database status/alert and other report functions, software tools and links to scanned documentation. Ensures that information is current and accurate. Archives documents based on retention schedules.
- Credentialing Standards: credentialing standards as prescribed and actively participates in credentialing standards development contributing to standards and consistency in database entry to ensure accurate and consistent processes. Provides updates on outstanding items.
- Medical Staff Dues: Processes check requests for Medical Staff dues based on invoices provided by various hospitals. Ensure that invoices are accurate prior to submitting payment.
- Back-up Coverage: Provides hospital and payer credentialing back-up coverage for other members of the Credentialing group.
Education and Experience:
- CPCS or CPMSM Certification by NAMASS Preferred
- AA or BA Preferred; work experience may substitute for education
- Credentialing certification preferred; ongoing education encouraged
- Knowledge of medical terminology preferred
- Minimum of 4 years of experience in hospital credentialing and managed care credentialing
We offer market-competitive compensation and a full range of benefits, including:
- A choice of two health plans, flexible spending and health savings accounts
- A 401(k) with a profit-sharing component
- Paid Time Off and Holiday Pay
- Life and disability insurance
- Learning opportunities through professional development programs
Thank you for taking the time to learn more about Radia and applying online! Radia is committed to employing a diverse workforce. EOE