Job Description
The Credentials Evaluation Analyst provides mentorship and support to medical staff leadership in the evaluation of credentials and practice information as it relates to the granting of Medical Network credentials. Contributes to the planning, structuring and monitoring of credentialing activities, and assists with high-profile/sensitive credentialing projects. Works in collaboration to implement the best standard methodologies, recommends policy/procedure changes and provides input about work products.
Duties and Responsibilities:
- Collaborate with the Credentialing Logistics Department. Evaluates individual practitioner credentials files (both electronic and paper files) to ensure that information acquired from the Credentials Coordinators/Credentials QC Analysts meets established specifications. Pursues additional information as ne. Investigates issues of concern in cooperation with applicable individuals and/or departments. Raises and makes recommendations to resolve issues that do not conform to established expectations to Credentialing Manager or consultation with other appropriate collaborators as required.
- Assess practitioner files to determine the presence or absence of possibly adverse or incomplete information that may impact Medical Network credentialing decisions in accordance with established criteria. Pursues problematic, missing or incomplete information in conformance with established procedures. Summarizes the results of the assessment in the file audit summary report.
- Evaluates credentials/qualifications against credentialing criteria. Assesses data/information provided against criteria for credentials requested and recommend actions for resolution. Pursues problematic, missing or incomplete information in conformance with established procedures. Summarizes the results of the assessment in the file audit summary report.
- Maintains lines of communication on work products and evolving issues of concern with regard to applicants/re-applicants with CMO/Medical Director, Quality Credentials QC Analysts/Coordinators, clinical department managers and Clinical Privileging Quality Manager, as applicable.
- Supports Practitioner Evaluation. Serves as a liaison and provides support for the pre-Credentials Committee review (as applicable) of both initial applicants and applicants for renewal. Facilitates a detailed and comprehensive evaluation as related to granting, continuing, denying or rescinding Medical Network credentials.
- Collaborates with Patient Safety and Peer Review Department. Collaborates with applicable individuals regarding related peer review and quality issues to improve the identification of professional practice trends that impact quality of care and patient safety. Ensures that the results of these evaluations are considered by the CMO/Medical Director, Quality when recommendations regarding continued credentialing occur.
- Acts as a resource. Provide expert internal consultation and facilitation to collaborators regarding credentialing matters related to assigned specialties.
- Identifies and works to implement the best standard processes. Makes recommendations to policy/procedure changes. Works to resolve issues related to high-profile and critical credentialing projects with the help of the privileging manager.
- Performs data entry of information into MSOW in accordance with established guidelines. Works accurately to ensure the integrity of data entered into MSOW. Uses MSOW including work processes, jobs and tasks and maintenance of fields in accordance with established standards. Completes training and maintains proficiency throughout MSOW development.
- Day to day work reflects an understanding of departmental operations, including the achievement of goals and objectives. Assists in research and development of department protocols and privilege forms to reflect clinical practice advances and changes in regulatory requirements. Participates in departmental activities that improve processes and efficiency and reduce waste.
Qualifications
Education:
High school diploma/GED required. Associate degree/College diploma/Bachelor's degree in Credentialing/privileging or healthcare related field of study preferred.
License/Certification:
Certified Provider Credentialing Specialist (CPCS) preferred. Certified Medical Staff Coordinator (CMSC) preferred. Certified Medical Staff Coordinator (CMSC) preferred.
Experience:
Three (3) years of experience in a clinical credentialing required.
About Us
About the Team
Req ID : 5577
Working Title : Credentials Evaluation Analyst - Quality Management
Department : MNS Quality Mgmt
Business Entity : Cedars-Sinai Medical Center
Job Category : Compliance / Quality
Job Specialty : Credentialing & Licensure
Overtime Status : EXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $34.00 - $52.70
Our compensation philosophy
We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above takes into account the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. Pay Transparency Non Discrimination Provision (PDF) (opens in new window)
Diversity and Inclusion at Cedars-Sinai
We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve – because that’s what our patients, colleagues and communities deserve. Quality Care and Research—For All, By All (opens in new window).
Cedars-Sinai is an Equal Employment Opportunity employer.
Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.
Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.
At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu) and COVID-19. For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines such as COVID-19 as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy. Cedars-Sinai’s AA Policy Statement (PDF) (opens in new window)
