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Hospital Privileging Team Lead

Hospital Privileging Team Lead

Job ID 
2018-2005
# of Openings 
1
Job Locations 
US-NJ-Marlton
Posted Date 
1/12/2018

More information about this job

Overview

Position Summary

 

InSight Telepsychiatry is seeking a hospital privileging team lead to work with the medical affairs team in Marlton, NJ and connect regularly to a national team of colleagues. This position is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process for providers. The hospital privileging team lead will facilitate all aspects of credentialing (obtaining hospital/facility privileges), including initial appointment, reappointment, the expirables process and clinical privileging for providers. This position will ensure interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing. The hospital privileging team lead is responsible for the accuracy and integrity of the credentialing database system and related applications. They will work under the supervision of the director of medical affairs.


Organization Overview


InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. With over 18 years of telepsychiatry experience and an active footprint in telepsychiatry-related advocacy, InSight is recognized as an industry thought-leader. InSight is the telemedicine arm of the CFG Health Network, a behavioral health organization that delivers onsite services across the spectrum of care. These roots in onsite care influence InSight’s approach to appropriate, quality services delivered through telehealth. www.InSightTelepsychiatry.com

Responsibilities

Job Responsibilities

 

Enrollment Job Processing (60%)

  • Ensure applicant eligibility by analyzing a provider’s profile and accompanying documents
  • Work closely with provider to obtain missing documentation and/or signatures pertaining to privileging
  • Confirm receipt of requested documents, identify and respond to issues that require additional investigation and evaluation, validate discrepancies with provider and facilitate process for obtaining hospital privileges
  • Perform timely follows-ups, maintain and update database on the status of application and report to management and provider
  • Work with hospital/facilities to obtain and track Med Exec meetings, credentialing committee meetings and board review dates for all partner facilities
  • Work with credentialing vendor to facilitate completion and tracking of outsourced privileging jobs
  • Monitor privileging reappointment/expiration dates and complete reappointment applications
  • Maintain current copy of appointments and privileges in database
  • Monitor initial, reappointment, FPPE and OPPE process for provider ensuring compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS, federal and state), as well as medical staff bylaws, rules and regulations, policies and procedures and delegated contracts
  • Maintain and utilize credentialing database to optimize efficiency, perform document generation, track application status and report

 

Staff Support (20%)

  • Serve as main support and mentor to privileging coordinators responsible for submission of new privileging applications as well as maintenance of existing privileges, tracking for reappointment or re-credentialing periods
  • Train and coach privileging coordinators to improve their professional knowledge and skills
  • Monitor and ensure compliance with P&P and Standard Operating Procedures
  • Assist in creating or revising workflows, procedures, policies and or standards as needed
  • Assist in assigning medical affairs jobs to the appropriate privileging coordinator
  • Monitor and balance the workload of privileging coordinators to ensure efficiency and maximum productivity
  • Regularly communicate updates, including expected completion dates, internally and externally
  • Assist the medical affairs director in identifying barriers or challenges to timely completion of medical affairs jobs and help put solutions in place, including escalation and communication protocols

 

External/Internal Communication, Report and Special Projects (20%)

  • Serve as a liaison for medical affairs with partner counterparts
  • Meet with Medical Affairs Director and Project Manager regularly to provide updates
  • Support the medical affairs director in establishing goals and benchmarks for enrollment team and regularly monitor and report on the progress of these goals
  • Support quality assurance initiatives and create an environment where QA outcomes drive performance of enrollment coordinators
  • Participate and support credentialing committee meetings as needed
  • Maintain delegated credentialing rosters, as needed
  • Overflow of credentialing jobs and other duties as assigned
  • Assist medical affairs department with special projects
  • Other duties as assigned

Qualifications

Job Requirements

 

  • High School Diploma
  • Two years of credentialing experience
  • Outlook, Excel, PowerPoint and Word proficiency
  • Database management skills, including querying, reporting and document generation
  • Ability to manage and impart confidential information
  • Independent worker
  • Organization and time management skills
  • Ability to multitask

 

Ideal Candidate

 

  • Previous healthcare experience
  • Working knowledge of clinical and/or hospital operations and procedures
  • Knowledge of initial privileging process, privileging reappointment and FPPE/OPPE processes
  • Knowledge of Echo Credentialing Software
  • Knowledge of NCQA standards as it relates to credentialing and health plan enrollment
  • Strong verbal and written communication skills
  • Informational research skills

 

Logistics

 

  • Full-time salaried position based in Marlton, NJ
  • Position available March 2018
  • Reports to Director of Medical Affairs, Medical Affairs Manager, or authorized designee


Please include your resume and a customized cover letter with your application.

 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

While performing the duties of this job, the employee is regularly required to stand, walk, and talk or hear. The employee frequently is required to use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and climb or balance. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must frequently lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus. EOE M/V/F/D