Medical Staff Services Specialist at Jobisite / America Jobs

This job ad has been posted over 40 days ago...

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Medical Staff Services Specialist

at Jobisite in Hawaii

Medical Staff Services Specialist
Waikiki Health has been providing healthcare services to our community for over 50 years. Thanks to our members and passionate and dedicated professionals, we have grown from our single Waikiki Drug Clinic, helping minimize the drug use among our community’s youth, to a multi-service, multi-site non-profit agency. Our mission is to provide quality medical and social services that are accessible and affordable for everyone, regardless of ability to pay. We strive to provide compassionate healing and expert care that result in improved health and quality of life for all in our island community. We work hard each day to better ourselves in order to care for our Hawaii Ohana. If you are looking for a career path that will make an everlasting difference in your community, Waikiki Health is right for you.
Waikiki Health is recruiting for a full time Medical Staff Services Specialist. The Medical Staff Services Specialist reports to the Quality and Organizational Effectiveness Director and evaluates, analyzes, and coordinates all aspects of the clinical staff licensing , credentialing, privileging , peer review, clinical quality review including processes for clinical staff practicing within Waikiki Health. They provide integral support to healthcare operations by enabling timely onboarding of healthcare providers and works closely with internal and external partners to ensure that all providers are sufficiently credentialed.

Duties include but are not limited to:
• Reviews, screens and monitors credentialing and privileging applications/renewal applications for completeness, accuracy, and compliance with federal, and state regulations, guidelines, Waikiki Health policies, and standards. Conducts primary source verification, collects, and validates documents to ensure accuracy of all credentialing and privileging elements; assesses completeness of information and qualifications relative to Waikiki Health credentialing criteria. Manages third-party insurance enrollment.
• Coordinates the peer review process and the quality chart review process which includes scheduling, notifying reviewers, receiving, and validating receipt of completed reviews.
• Processes and reviews NPDB (National Practitioner Data Base) enrollments and regularly checks for provider malpractice reports
• Communicates clearly with providers, their liaisons, internal partners of revenue cycle, human resources, and medical staff leadership and external partners, as needed to provide timely responses upon request on day-to-day issues as they arise.
• Collaborates with the Chief Financial Officer and Senior Compliance Officer during the annual liability insurance renewal for health center through the Federal Torts Claim Act.
• Other duties as assigned

Qualifications:
• Bachelor’s degree; or at least 2 years of experience related to the duties and responsibilities specified.
• Experience with project management, database management, program coordination and provider relations preferred.
• Health care experience preferred.
• Familiarity of Microsoft Office programs, including, but not limited to, Excel and Outlook.
• Bachelor’s Degree or a minimum of 2 years of experience in program coordination, program management or health care systems.
• Project management, database management, electronic medical record, and provider relations are preferred.
• Working with all types of insurance carriers including Medicare and Medicaid preferred.
• FQHC experience preferred.

Waikiki Health requires proof of the following immunization; with or without reasonable accommodation: TB skin test or chest x-ray, MMR, Hep B (optional), Covid-19.

Waikiki Health provides a comprehensive set of benefits to our employees, including 100% premium paid employee health care, voluntary life insurance, generous employer matching, paid holidays, paid time-off, and more. We are currently looking for compassionate and team-oriented individuals to join our organization. If you are interested in improving health and quality of life for all in our island community, please visit our website for more information.

Reference : Medical Staff Services Specialist jobs

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