Under the supervision of the Associate Director, the Credentialing Specialist is responsible for the execution of all activities related to the appointment or re-appointment of Members and Affiliated Members of the Medical Staff. This includes thorough evaluation of the application upon receipt against the Medical Staff Bylaws to determine eligibility and troubleshooting all steps throughout the processing of each application to ensure completeness and compliance with applicable Medical Staff Bylaws, Department Policies and Procedures, Joint Commission (JC), State of Connecticut Department of Public Health (DPH), Centers for Medicare and Medicaid Services (CMS) and National Committee on Quality Assurance (NCQA) regulations. The Credentialing Specialist is also responsible for the completeness and accuracy of all data entry including demographic and clinical privilege information which is used both in the Medical Staff Administration Department and hospital-wide.
Experience in a hospital, medical group practice, or other similar health care environment and familiarity with physician specialties required. Previous experience in credentialing preferred.
Two to three years experience in the healthcare industry supporting an understanding of physicians and physician specialties required., CPMSM or CPCS desirable but not required.
Internal Number: 1
About Yale New Haven Health
Yale-New Haven Health System is the largest health system in Connecticut, comprised of five (5) acute care hospitals with over 6,000 medical staff members. Yale New Haven, a 1,500 bed hospital is the anchor institution and primary affiliate of the Yale University School of Medicine.
Every employee understands and shares in the Yale New Haven Health System Vision, supports its Mission, and lives its Values. These values: integrity, patient-centered, respect, accountability, and compassion guide what we do, as individuals and professionals, every day.