Medical Staff Credentialing Manager jobs in Rhode Island

Job Summary:

Responsible for processing initial applications and reappointment applications to credential and privilege physicians and other licensed health care professionals of the medical staff of Care New England Health System (CNE). Performs primary source verifications and evaluates information to ensure applicants meet criteria in accordance with CNE's Medical Staff Bylaws, Rules & Regulations, Policies and Procedures, and all requirements of accrediting organizations and regulatory agencies.

Duties and Responsibilities:

Reviews and processes applications from individuals seeking medical staff appointment and clinical privileges, ensuring all required documentation is provided.

Conducts thorough background checks, including verifying educational degrees, professional licenses, certifications, work experience, current clinical competence and any other relevant credentials.

Collaborates with applicants, professionals, organizations, and internal teams to provide guidance and support throughout the credentialing process, responding to inquiries, and resolving issues.

May train and mentor new staff, as assigned. Identifies potential problems and proposes solutions.

Updates the database in accordance with standardized workflows and data entry rules.

Evaluates practitioners against threshold criteria and notifies Medical Staff Manager of issues.

Applies knowledge, expertise, sound judgment and consults with team members as necessary to resolve questions or concerns.

Performs other duties as assigned.

Requirements:

High School Diploma or GED required; Associate's Degree Preferred.

Minimum 5 years experience required.

Certified Provider Credentialing Specialist (CPCS) preferred.

Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting the nation’s top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.