RN Medical Staff Performance Improvement Credentialing Coordinator

Overview

CentraState Healthcare System, headquartered in Freehold, New Jersey, is a leading nonprofit healthcare provider dedicated to serving the community. Its comprehensive network includes CentraState Medical Center, a community-focused hospital, along with an ambulatory campus, two senior living facilities, three free-standing community health pavilions, and a charitable foundation. As the third-largest employer in Monmouth County, CentraState has earned repeated recognition as a Great Place to Work-Certified™ company, reinforcing its reputation as an exceptional workplace. 

The RN Medical Staff Performance Improvement and Credentialing Coordinator supports and coordinates the Medical Staff Performance Improvement, Peer Review, and Focused Review functions and activities in compliance with the Medical Staff Quality Improvement Plan and related policies and procedures. The Coordinator works closely with other departments of CentraState Medical Center to obtain appropriate quality information such as Risk Management, Quality and Patient Safety, and Information Technology and Support under the supervision of the Chief Medical officer. Additionally the RN Medical Staff Performance Improvement and Credentialing Coordinator under the supervision of the Manager of Medical Affairs coordinates and processes the credentialing of reappointment applications for Medical Staff membership and/or privileges in accordance with the Medical Staff Bylaws and Departmental Rules and Regulations so as to assure the maintenance of qualified practitioners who provide patient care in the hospital. The Coordinator notifies applicants and Hospital personnel of action(s) taken per established Departmental policies/procedures. The coordinator processes and monitors medical staff quality improvement.

Schedule: Monday through Friday- 8a-4p.  Must be flexible to work outside typical hours.

Responsibilities

• Supports the work of the Medical Staff Quality Review Committees through case review for clinical quality, documentation, and professional behavior
• Participates in collecting and reviewing of quality data, working closely with the Medical Staff Departments and quality committees, as well as individual physicians in reviewing the performance report information.
• Works in conjunction with department chairperson, VP Medical Director of Quality, and Chief Medical Officer on medical staff department quality initiatives
• Conducts medical staff case reviews and works in conjunction with the VP Medical Director of Quality, Chief Medical Officer, and department chairpersons
• Supports and coordinates the Medical Staff Performance Improvement and Peer Review
• Works closely with the Manager in regard to Focused Professional Performance Evaluation(FPPE) and Ongoing Professional Performance Evaluation (OPPE) for regulatory compliance
• Maintains OPPE and FPPE records on medical staff, supports department chairpersons in development of FPPE plans
• Tracks and trends medical staff FPPE and OPPE
• Coordinates and provides administrative support (preparing agendas, taking meeting minutes) for departmental/medical staff committee meetings as assigned
• Initiates the credentialing process, including the dissemination of reference requests and state and federal verification correspondence
• Maintains continuous contact via phone, email and/or in person with candidates for reappointment and all agencies and intuitions who have been requested to supply credentialing information
• Reviews and organizes all data received and prepares reappointment files for presentation to Credentials Committee, Department Chairpersons, and the Medical Executive Committee
• Enters provider data into appropriate systems and appropriately notifies other departments of these changes as needed
• Drafts correspondence and requests for information, following department policy for release of information
• Closely monitories information collection; cognitive analysis of all information received, evaluates adequacy and quality and pursues additional information if necessary
• Is responsible for the technical and administrative support of all functions of the Office of Medical Affairs as required or assigned. These functions include but are not limited to, updating changes to provider profiles, answering incoming telephone calls, scanning/indexing Credentialing documentation in electronic credentialing software system, monitoring Physician Lounge for cleanliness and availability of supplies
• Communicates to the Manager of any concerns relative to the Office of Medical Affairs
• In conjunction with the Manager of Medical Affairs, handles and/or is kept up to date on all confidential or sensitive issues concerning Medical Staff members and activities.

Qualifications

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