Privileging Specialist Sr.
Job Title: Privileging Specialist Sr.
Date Posted: 12/01/2016
Position Number: 54495
Allegheny Health Network is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities. With more than 17,000 employees including 7,400 health care professionals, nearly 200 primary care and specialty care practices, Allegheny Health Network includes seven hospitals in Pennsylvania with nearly 2,400 licensed beds.
Allegheny Health Network’s clinical expertise ranges from primary care to the most complex surgical procedures. Services include cancer diagnosis and treatment, cardiovascular care, neurological and neurosurgical services, organ transplantation, orthopedic and rehabilitation services, and women’s health.
Status: Full-Time
Non-Union
Job Summary: Coordinates and oversees the privileging process for appointment and reappointment of both physicians and allied health professionals with the requirements of the Medical Staff Bylaws and all federal/state regulatory and/or accrediting agencies.
Job Responsibilities:
- Act as Senior Privileging Specialist and monitor the privileging process for medical staff and allied health professionals for initial appointments, focused professional practice evaluations, ongoing professional practice evaluations, reappointment, change in status and/or privileges and temporary privileges for AGH, WPH and FRH ensuring compliance with all Federal and State regulatory requirements (Joint Commission, Department of Health).
- Coordinate work flow and review the work of other privileging staff members.
- Acts as the delegate for all Managed Care Audits, reviewing files and presenting files during all audits ensuring 100% compliance with NCQA standards.
- May coach and train privileging staff.
- Maintains and utilizes a comprehensive computer database for the privileging function including providing data reports as required or requested.
- Facilitates organization and development of monthly Credentials Committee and Allied Health Professional
- Subcommittee agendas.
- Performs other duties as assigned or required.
Education: Associates degree preferred.
Licensure/ Certification/Registration: CPCS - Certified Provider Credentialing Specialist required or obtained within 5 years of hire.
Complexity of Work: Works independently within the scope of the position. Analytical ability to assess supporting data for privileges requested. Ability to communicate with all levels and Medical Staff leadership. Demonstrates ability and initiative to organize and prioritize duties.
Required Experience: Minimum of 4 years experience in medical staff credentialing. Strong knowledge of medical terminology. Excellent written communication skills to create letters and emails to providers and administrators in the organization.