Credentials Specialist - Nemours Enterprise, Florida and Delaware Campuses at Nemours in Wilmington, Delaware

Job Description:

Nemours is seeking a Credentialing Specialist to join our team! This position is based in Delaware Valley with remote options.

This position will follow department policies and procedures, collect data for the verification and evaluation of providers applying for initial appointment. Individuals in this role interact with applicants, liaisons, department chairs, division chiefs, medical staff leaders and Nemours management. Through the work performed individuals in this position assist the Department in complying with applicable accreditation standards. The individuals in this role are responsible for maintaining accurate and complete credentials files, maintaining credentials database, identifying potential issues, and communicating this information to the appropriate reviewers.

Responsibilities:

• Coordinates and processes initial credentialing and privileging applications in a manner that assures compliance with applicable accreditation standards and Medical Staff policies.
• Processes reappointment applications as needed.
• Obtains and evaluates information from primary sources.
• Analyzes applications and supporting documents for completeness and informs the practitioner of the application status, including the need for any additional information.
• Recognizes, investigates, and validates discrepancies and adverse information obtained from the application, primary source verifications, or other sources and communicates with Director and others regarding these matters.
• Compiles, evaluates, and presents the practitioner-specific data collected for review and recommendation by the Medical Staff.
• Assists in maintenance of systems to track expiring credentials.
• Verifies and documents expirables using acceptable verification sources to ensure compliance with accreditation and regulatory standards.
• Provides responses to external queries regarding practitioners' status.
• Maintain accurate, complete and timely information in the electronic credentialing data base.

• Experience in Medical Staff credentialing and privileging is required.
• ECHO or MD STAFF experience is preferred.
• Knowledge of related accreditation and certification requirements
• Knowledge of medical staff policies, regulations, and bylaws.
• Ability to communicate effectively, both orally and in writing with all levels of the organization
• Ability to use independent judgment and to manage confidential information.
• Ability to be flexible - prioritizes change rapidly, must have ability to adapt to changes/interruptions.
• Current NAMSS certification as a Certified Provider Credentials Specialist preferred.
• Associates Degree - In lieu of the educational requirement, previous work history in credentials and years of experience may be considered.