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Kaiser Permanente Careers

Quality Assurance, UR & Case Management

Passion + Vision + Integrity = Excellence

Ensure consistency and the highest ethical standards across our entire organization. Our quality assurance team drives ongoing improvement by fostering an environment of support, providing technical and specialized consultative services, and inspiring ongoing excellence.

Credentials Administrator II

Location: Oakland, CA Additional Locations:
Job Number: 856097 Date posted: 01/14/2020
Description:

Under supervision, initiates the credentialing process, compiles, and processes data in compliance with Federal, State, Program, and Regional requirements. Ensures thorough and timely verification of physicians credentials according to regional Credentialing Policies and Procedures. Acts as liaison between medical centers and medical offices credentials and privileges coordinators and the regional office.



Essential Functions:


 - Ensures consistent documentation and complete verification of physicians credentials. Provides required documentation to appropriate physicians managers and committees in the practice sites.


- Processes all credentials applications and/or applications for employment with TPMG.


- Initiates extensive investigation into the applicants background, education and experience through the use of on-line systems, written correspondence, telephone inquiries and printed reference guides and reports.


- Partners with the practice site Credentials&Privileges Coordinators to ensure an integrated, timely, consistent product. 


- Collaborates with professional physician recruiters to monitor recruitment status of candidates to ensure timely credentialing prior to employment.


- Develops and maintains a computerized data base of physician data for use in the credentialling and appointment process. Prepares reports as requested.


- Maintains files of current Scopes of Practice for all specialties, Professional Staff by-laws for all medical center and current Federal, State, Program and Regional requirements. 


- Implements efficient and effective combinations systems for transmission of credentials information to practice sites to facilitate timely approval to participate and professional staff appointment. 


- Keeps abreast of changes in laws and regulatory requirements. Writes and implements new procedures as necessary to remain in compliance.


- Works with practice site Credentials and Privileges Coordinators to share and implement best practices whenever feasible. 


- Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status. Such changes are generally implemented only after notice is given to affected employees.

Basic Qualifications:
Experience
- Minimum three (3) years of experience with credentialing in a hospital setting.
Education
- Associate's degree required, OR two (2) years of experience in a directly related field.
- High School diploma or General Education Development (GED) required.
Licenses, Certifications, Registrations
- N/A.


 


Additional Requirements:
- Proficient with IBM PC, dBase, WordPerfect, and Lotus 1-2-3.
- Proficient with Medical Terminology.
- Significant knowledge of Federal and State regulatory requirements and accreditation standards e.g., The Joint Commission, TITLE
22, NCQA, NPDB, and certifying agencies.
- Strong organization and communication skills and attention to details required.
- Proven ability to function independently with minimal direct supervision.
- Must be able to work in a Labor/Management Partnership environment.


 


Preferred Qualifications:
- Experience with Med Staff or Medical Information Data Analysis System preferred.
- Bachelor's degree preferred.
- Certification as Certified Provider Credentialing Specialist (CPCS) preferred.


 

Primary Location: California,Oakland,1950 Franklin 1950 Franklin Scheduled Weekly Hours: 40 Shift: Day Workdays: Monday - Friday Working Hours Start: 8:00 AM Working Hours End: 4:30 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Non-Union, Non-Exempt Job Level: Individual Contributor Job Category: QA / UR / Case Management Department: Regional Credentialing and Privileging Travel: No Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

About QA, Ur & Case Management Careers

Careers In QA, Ur & Case Management

As an organization, we are committed to delivering the same exemplary care no matter who you are, where you are, or what your needs. But how are those standards defined, measured, and assessed? That's where our quality assurance team comes in. Implementing the action plans and initiatives that will drive successful practices, you'll work across the organization to foster the necessary education, communication, and innovation that will enable us to operate as one KP — with our mission and goals in complete alignment.

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