What Will I be Doing in this Role?
The Credentials Evaluation Analyst provides guidance and support to medical staff leadership in the evaluation of credentials and practice information as it relates to the granting of clinical privileges. Contributes to the planning, structuring and monitoring of credentialing activities, and assists with high-profile/sensitive credentialing projects. Works in collaboration to implement standard processes, recommend policy/procedure changes and provide input about work products.
Collaborates with Credentialing Logistics and Information Department - Evaluates individual practitioner credentials files (both electronic and paper files) to ensure that information received from the Credentials Coordinators/Credentials QC Analysts meets established specifications. Pursues additional information as necessary. Investigates issues of concern in cooperation with applicable individuals and/or departments.
Advances and makes recommendations to resolve issues that do not conform to established expectations to Credentialing Manager or consultation with other appropriate partners, as required.
Identifies/Flags Potentially Adverse Information - Assesses practitioner files to determine the presence or absence of potentially adverse or incomplete information that may impact medical staff membership or privileging 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.
Evaluation of Credentials /Qualifications Against Privileging Criteria - Assesses data/information provided against criteria for privileges 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.
Communication - Maintains lines of communication on work products and evolving issues of concern with regard to applicants/re-applicants with medical staff leadership, Credentials QC Analysts/Coordinators, clinical department managers and Clinical Privileging Quality Manager, as applicable.
Interview Coordination – Coordinates completion of interview for initial applicants. In accordance with the New Applicant Work Process (Jobs & Tasks) conducts follow-up as prompted by task list. Follows-up with interviewer to facilitate completion of Interview Summary & Recommendation form. Coordinates any additional follow-up necessary to resolve areas of concern.
Support of Practitioner Evaluation – Serves as a liaison and provides support for the divisional review, department chair review and 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 privileges.
Collaboration with Patient Safety and Peer Review Department -- Collaborates with applicable individuals regarding related competency management activities associated with Ongoing Professional Practice Evaluation (OPPE) to promote the identification of professional practice trends that impact quality of care and patient safety. Ensures that the results of these evaluations are considered by division chiefs and department chairs when recommendations regarding continued privileging occur. Sends notification of conditional appointments/privileges to Quality Improvement department and tracks for compliance
Acts as a resource - Provides expert internal consultation and facilitation to partners regarding credentialing and privileging matters related to assigned specialties.
Facilitates completion of Focused Professional Practice Evaluation (FPPE) for practitioners in assigned specialties whenever new privileges are granted. Ensures that the results of these evaluations are considered by division chiefs and department chairs as they confirm clinical competence. Collaborates with the Patient Safety and Peer Review Department when the medical staff organization determines that focused review of an individual's clinical practice is required due to potentially adverse information.
Identifies and works to implement best practices. Makes recommendations to policy/procedure changes.
Works to resolve issues related to high-profile and sensitive credentialing projects with the help of the privileging manager.
- High School Diploma/GED required. Bachelor’s degree in credentialing/privileging or related major preferred. Closely related health care position with demonstrated knowledge of medical terminology and clinical nomenclature preferred.
- Clinical credentials (i.e., Registered Nurse) preferred.
- Certification or eligibility for Certification by the National Association of Medical Staff Services (NAMSS) as a Certified Medical Staff Coordinator (CMSC) or Certified Provider Credentialing Specialist (CPCS) preferred or attained within two (2) years of hire date.
Experience/Skills We're Seeking:
- Proficiency in software applications to include use of menu driven, word-processing and spreadsheet applications. Ability to draft business correspondence and ensure correct punctuation, spelling and grammar. Ability to perform simple mathematical calculations.
- Ability to interact effectively with Medical Staff Leadership, Senior Management, Directors, Managers, Physicians, internal staff and representatives of public agencies and businesses inspiring confidence and credibility of process and work products.
- Ability to manage multiple priorities and/or projects and tasks in a fast-paced, dynamic and complex environment. Flexibility to accommodate unstructured situations and changing priorities.
- Demonstrated ability to handle multiple tasks with short timelines, to prioritize and organize work, and to complete assignments in a timely, accurate manner.
- Ability to work independently and use independent judgment while providing excellent service.
Req ID : 361
Working Title : Credentials Evaluation Analyst
Department : Medical Staff Administration
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 : $35.25 - $54.64
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)