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 IILocation: South San Francisco, CA Additional Locations:
Job Number: 866191 Date posted: 05/28/2020
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.
- 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.
- Minimum three (3) years of experience with credentialing in a hospital setting.
- 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
- 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.
- Experience with Med Staff or Medical Information Data Analysis System preferred.
- Bachelor's degree preferred.
- Certification as Certified Provider Credentialing Specialist (CPCS) preferred.
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.
See What People are Saying About Working at KP
January 11, 2020
- Positive Outlook
- Approves of CEO
I have been working at Kaiser Permanente full-time for more than a year
Interesting and challenging projects, excellent benefits, awesome co-workers, and ability to work from homeFull Review
Come introduce yourself to a member of the Kaiser Permanente team at an upcoming career or professional event. We look forward to meeting you in person.
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