The Credentialing Administrator position creates processes to ensure that quality measures and targets are defined and documented for the credentialing, privileging, and peer-reviewing of all licensed medical and nursing professionals.  This is accomplished by researching, selecting, and implementing an on-line system to manage the credential process.  This position will also train facility staff on proper utilization of the system and ensure credentialing and privileging are consistent and standardization throughout the organization.  This position will be a single point of contact for physician and other licensed health care professionals, Health Services Administrators and Corporate, Regional and Human Resources to expedite the gathering of credentialing information.

Primary Duties and Responsibilities

  • Develops standardized tools and process for the use of credentialing, privileging, and peer-reviewing all licensed medical and nursing professionals.
  • Researches web-based and software database solutions to manage the credentialing process.  Introduces database system to all facilities, develops a process for maintaining it, and providing necessary staff training on proper usage. 
  • Assists facilities in implementing processes for reviewing, auditing, and verifying credentialing, privileging and peer review compliance and internal quality control programs. 
  • Responsible for updating the database  and Corporate Policy to reflect new Joint Commission standards and revises other policies to address new The Joint Commission, ACA, NCCHC, PBNDS standards  and organization needs.
  • Assists corporate management in developing a timeline for introducing database system to all facilities, software set-up, tool design and development and training program.
  • Assists with developing a comprehensive self-assessment tool to be utilized at each facility to ensure, track, and monitor compliance related to credentialing, privileging, peer review, accreditation, and regulatory standards.
  • Assists with the development of a formal compliance training program across all levels of the organization.  Designs a professional development program to ensure continuing education opportunities related to process improvement initiatives and best practice implementation.
  • Assists with managing reporting requirements and monitoring service levels and compliance.
  • Prepares facilities for external agency audits and work with external auditors to complete audits along with follow-up activity as related to credentialing, privileging and peer review compliance.
  • Performs other duties as assigned.