Title:Credentialing Coordinator I, CVO

Location: Fountain Valley, CA / Predominately Remote (Must be located in Southern California)

Department: Central Verification Office SS

Status: Full-Time

Shift: Days (8hr)

Pay Range*: $29.76/hr - $43.16/hr

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

Credentialing Coordinator I is responsible for coordinating all provider credentialing activities for the Central Verification Office at MemorialCare and acts as a liaison between the hospital medical staff departments, medical group and IPA credentialing departments, as well as the providers and their office staff. The position provides oversight for credentialing and is responsible for the timely and accurate processing of all applications and related documents required to meet regulatory and plan requirements for credentialing.

Essential Functions and Responsibilities of the Job

1. Monitor and maintain timeliness while processing initial credentialing and re-credentialing files for physicians, mid-level practitioners, and other ancillary providers
2. Responsible for tracking practitioner applications, verifications and other pertinent information regarding credentialing files for correctness, compliance and completeness according to regulations and standards.
3. Communicate with practitioners, practitioner’s office staff, internal departments and outside institutions regarding credentialing status, verifications and activities.
4. Update and maintain accurate credentialing database for both practitioner data and institution tables.
5. Prioritize work activities and track progress on all files.
6. Maintain a strict degree of confidentiality in all areas relating to provider credentials and status.
7. “Other duties as assigned”

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Minimum Requirements

Qualifications/Work Experience:

• 2 years related experience and/or training with an understanding of hospital medical staff requirements, health plan eligibility and health care benefits, or equivalent combination of education and experience.
• Minimum of 2 years related experience with Joint Commission/hospital medical staff credentialing and managed care NCQA credentialing along with the understanding of the associated regulatory requirements.

Education/Licensure/Certification:

• Associates degree (A.A.) in Medical Staff Management (MSSM) or equivalent from two year college or technical school preferred; Certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) preferred.