Duties
and Responsibilities : Accountability #1 : Physician’s Credentialing Process
- Manages the credentialing and re-credentialing processes for physicians.
- Reviews and processes applications for new appointments, reappointment applications and all other change recommendations.
- Maintains the integrity of the physician databases, including CMaRs, ensuring completeness and accuracy.
- Processes atypical applications to meet required deadlines while aligning to Medical and Dental Staff By-laws.
- Ensures appropriate documentation is obtained in keeping with the Medical and Dental Staff by-laws and the Ontario Public Hospitals Act.
- Coordinates with licensing boards, hospitals, and insurance companies to obtain necessary credentials.
- Maintains up-to-date knowledge of regulatory requirements and accreditation standards.
- Liaises with the respective Colleges regarding professional conduct complaints.
- Provides guidance and direction to candidates regarding obtaining licensure in the Province of Ontario.
- Acts as a resource to the MAC, Clinical Directors and Chief of Staff regarding credentialing.
Accountability #2 : Administration
- Reviews reports and documentation for legitimacy, accuracy and completeness.
- Administers leave of absence process for credentialed professional staff.
- Updates credentialing data systems / databases.
- Organizes and maintains confidential files for professional staff in adherence to hospital guidelines.
- Creates, proofreads, edits, and maintains a variety of correspondence
Accountability #3 : Communications
- Communicates effectively with providers and internal / external stakeholders to resolve credentialing issues promptly.
- Fosters positive relationships with other departments to assist with the onboarding of new physicians as the credentialing process is completed.
- Actively participates in discussions with relevant stakeholders about the process going forward to its conclusion.
Accountability #4 : Process Improvement
- Collaborates closely with various programs to streamline credentialing processes and maintains compliance with accrediting bodies.
- Ensures that credentialed professional staff are credentialed in accordance with regulatory standards and hospital policies.
- Responsible for implementation and monitoring of policies and processes to ensure credentialing best practice processes are implemented.
- Participates in audits and quality improvement initiatives related to provider credentialing.
- Assists with developing and implementing policies and procedures related to credentialing and makes recommendations for improvements in alignment with the hospitals' overall organizational strategy.
Accountability #5 : Human Resources
- Facilitates the process for new medical staff recruits, serving as a contact for all Clinical Directors and the Chief of Staff to advise on credentials policies and procedures.
- Creates and implements internal notification systems of all new staff and / or changes in privileges, to enable new staff or temporary staff to function within the Hospital.
- Prepares job postings for internal and external advertisements.
Accountability #6 : Other
- Works in a manner that complies with staff and patient / client safety practices, policies and procedures of The Royal.
- Ensures a work environment that is conducive to the Royal’s Anti-Racism, Harassment, Discrimination-Free Workplace and work safety policies and practices.
- Demonstrates commitment to health equity, values diversity and contributes to an inclusive working environment.
Skills, Abilities and Qualifications :
- Bachelor's degree in healthcare administration, health information management, business administration, or a related field.
- Minimum of 3 years of experience in physician credentialing or medical staff services.
- Certified Provider Credentialing Specialist (CPCS) preferred.
- Strong understanding of credentialing principles, accreditation standards and regulations relevant to Ontario, such as those from the College of Physicians and other regulatory bodies.
- Knowledge of federal and provincial laws related to healthcare credentialing, privacy (., PHIPA - Personal Health Information Protection Act), and professional standards.
- Demonstrated excellence in verbal and written communication and interpersonal skills.
- Demonstrated ability to work with confidential information.
- Excellent organizational skills with meticulous attention to detail.
- Ability to assess, understand and resolve issues and problems within scope of authority, escalating when necessary.
- Demonstrated computer proficiency in word processing, spreadsheets and database systems (Windows, Word, Excel, Access, PowerPoint) and using credentialing software and databases.
- Ability to work independently and collaboratively in a team-based environment.
- Capability to analyze credentialing issues and develop solutions in compliance with policies and regulatory requirements.
Salary Range : $40.02 to $47.41 per hour
30+ days ago