CREDENTIALING COORDINATOR, VENTURA COUNTY, CA

Posted on September 24th, 2024

Salary: $57,887.18 - $81,187.67 Annually

Location: Ventura, CA

Job Type: Full-Time Regular

Job Number: 0735HCA-24AA (LC)

Department: Health Care Agency

Opening Date: 08/16/2024

Closing Date: Continuous

Description

WHAT WE OFFER

  • A general salary increase of 3.5% effective December 22, 2024.
  • Educational Incentive - An educational incentive of 2.5% for completion of an associate's degree, 3.5% for completion of a bachelor's degree, OR 5% for completion of a graduate's degree.
  • Bilingual Incentive - Proficiency levels by exam are $.69 per hour (Level I), $1.00 per hour (Level II), or $1.32 per hour (Level III).
  • Vacation Accrual – New regular, full-time employees shall accrue approximately 14 days of vacation a year for the first 10,400 hours or 5 years of service; vacation accruals increase at 5, 11, 12, 13, 14, 15 and 20 years of service topping out at 26 days a year and 400 hours of vacation hours banked.
  • Vacation Leave Redemption – After 14,560 hours of continuous service an employee may elected to "cash in" or redeem up to 80 hours of vacation accrued in the same year after using 80 hours of vacation in the preceding 12 months.
  • Sick Leave - Full time regular employees accrue 3.08 hours of sick leave per pay period with an advance at hire of 40.04 hours which will be balanced at the completion of 13 bi-weekly pay periods.
  • Deferred Compensation - Eligible to participate in the County's 401(k) Shared Savings Plan and/or the Section 457 Plan. This position is eligible for up to a 3% match on your 401(k) contributions.
  • Health Plans – Full time employees are afforded a flexible credit allowance for purchasing medical, dental, and/or vision insurance from a group of authorized plans: Tier one for employee only is $502 per biweekly pay period, tier two for employee plus one is $730 per biweekly pay period and tier three for employee plus family is $905 per biweekly pay period.
  • Flexible Spending Accounts - Choice of participation in the Flexible Spending Accounts which increase spending power through reimbursement of pre-tax dollars for IRS approved dependent care and health care expenses.
  • Pension Plan - Both the County and employees contribute to the County's Retirement Plan and to Social Security. If eligible, reciprocity may be established with other public retirement systems, such as PERS.
  • Holidays - 12 paid days per year which includes a scheduled floating holiday.

THE POSITION:
Under general supervision, is responsible for coordinating all aspects of the privileging and credentialing process of the licensed independent practitioners (LIPs) in accordance with the Medical Staff Bylaws, Rules & Regulations, Policies & Procedures, The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), and National Committee for Quality Assurance (NCQA) accrediting standards and regulatory requirements.

Distinguishing Characteristics:
This classification is allocated to the Ventura County Medical Center and is characterized by responsibility for analyzing and interpreting numerous regulations to which the medical staff bylaws, rules, regulations, policies, and procedures must conform. These positions are also responsible for advising all Medical Staff departments and Committees of any change or standard that impacts quality of care and Medical Staff administrative operations.

PAYROLL TITLE: Credentialing Coordinator I

AGENCY/DEPARTMENT: Health Care Agency - Ventura County Medical Center (VCMC)

Credentialing Coordinator I is represented by the Service Employees International Union (SEIU) and is eligible for overtime compensation..

TENTATIVE SCHEDULE:
OPENING DATE: 8/16/2024
CLOSING DATE: Continuous and may close at any time; therefore, the schedule for the remainder of the process will depend upon when we receive a sufficient number of qualified applications to meet business needs.
APPLICATION REVIEW: First review date expected to be on Friday, August 30, 2024.

Examples Of Duties

Duties may include but are not limited to the following:

  • Maintains knowledge and compliance with all regulatory and accrediting requirements;
  • Processes initial and reappointment applications, checking for completeness and accuracy, including primary source verification of confidential and sensitive practitioner information;
  • Ensures that all credentials files are current and complete pursuant to expiration date of medical licenses, board certification, professional-liability insurance coverage, DEA and other pertinent information, per bylaws, rules and regulations, and policies and procedures;
  • Maintains credentialing database (MD Staff) with current practitioner information;
  • Audits files based on internal standards and regulatory requirements;
  • Monitors and reports application status and provide appropriate correspondence as appropriate;
  • Assists with development and maintenance of Medical Staff delineation of privilege forms;
  • Coordinates and record assigned medical staff committee meetings;
  • Protects all credentialing information and files with strict confidence and limited access according to regulatory standards;
  • Participates in preparation for health plan annual audits and reports;
  • Maintains professional working relationship with Medical Staff, organization departments, clinics, and outside facilities;
  • Works independently with minimal supervision to meet specified timeframes;
  • Adheres to organization policies and procedures; and
  • Performs other related duties as required.

Typical Qualifications

These are entrance requirements to the exam process and assure neither continuance in the process nor placement on an eligible list.

EDUCATION, TRAINING, and EXPERIENCE

Current National Association of Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) or actively pursuing certification and certification obtained within two (2) years of eligibility to sit for the exam.

Intermediate computer skills using Microsoft products and web-based queries.


DESIRED

  • Previous hospital medical staff or managed care credentialing experience.
  • Experience with credentialing software.
  • Experience preparing agendas and taking minutes.
  • Certified Professional Medical Staff Management (CPMSM) certification
  • Knowledge, Skills, and Abilities
  • Working knowledge of TJC, NCQA, and CMS credentialing and privileging standards and experience with provider and/or health plan credentialing and delegated health plan credentialing audits.
  • Ability to manage and meet multiple priorities and competing deadlines; read and interpret complex documents, reports, and data; effectively and professionally communicate with providers, outside organizations, and staff, both verbally and in writing; and exercise sound spelling, grammar, and clear written communication.
  • Problem solving and organization skills with attention to detail.

Recruitment Process

FINAL FILING DATE: This is a continuous recruitment and may close at any time; therefore, apply as soon as possible if you are interested in it. Your application must be received by County of Ventura Human Resources no later than 5:00 p.m. on the closing date.

First review date expected to be on Friday, August 30, 2024.

To apply on-line refer to web site: www.ventura.org/jobs. If you prefer to fill out a paper application form, please call (805) 654-5129 for application materials and submit them to County of Ventura Human Resources, 800 S. Victoria Avenue, L-1970, Ventura, CA 93009.

NOTE: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible. If interested, please click here (Download PDF reader) for additional information.

NOTE: Sufficient information must be provided under the Education/Work experience portion of the application and supplemental questionnaire, if applicable, to thoroughly and accurately demonstrate your qualifications in order to determine eligibility. A resume may be attached to supplement the information in the above sections; however, it may not be submitted in lieu of the application.

APPLICATION EVALUATION – qualifying: All applications will be reviewed to determine if the stated requirements are met. Those individuals meeting the stated requirements will be invited to continue to the next step in the screening and selection process.

SUPPLEMENTAL QUESTIONNAIRE – qualifying: All applicants are required to complete and submit the questionnaire for this examination at the time of filing. The supplemental questionnaire may be used throughout the examination process to assist in determining each applicant's qualifications and acceptability for the position. Failure to complete and submit the questionnaire may result in the application being removed from consideration.

TRAINING and EXPERIENCE EVALUATION: A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire. The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining the better qualified candidates among those who have shown that they meet the stated requirements. In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the Department. Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process.

NOTE: The selection process will likely consist of an oral examination, which may be preceded by or replaced with, the score from a T&E, contingent upon the size and quality of the candidate pool. In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis. For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities. It is also highly recommended that the supplemental questionnaire within the application is completed with care and diligence.

ORAL EXAMINATION – 100%: All qualifying applicants, or those selected for further examination if there is a high number of qualified applicants, will be invited to an oral examination. A panel of three persons will conduct the oral examination to evaluate and compare participating candidates' knowledge, skills and abilities in relation to those factors determined to be essential for successful performance of the job.

ELIGIBILITY LIST: Candidates who score seventy percent (70%) or higher on the oral examination will be placed on an eligible list for one (1) year. If there are three (3) or fewer qualified applicants, an oral examination will not be conducted. Instead, a score of seventy percent (70%) will be assigned to each applicant, and each applicant will be placed on the eligible list. The eligible list established from this recruitment may be used to fill existing and future regular, temporary, fixed-term, intermittent and extra-help positions within the Ventura County Medical Center only. There is currently one (1) Regular vacancy.

BACKGROUND INVESTIGATION: A thorough pre-employment, post-offer background investigation, which may include inquiry into past employment, education, criminal background information and driving record, may be required for this position.

For further information about this recruitment, please contact Lorin Calderon by email to Lorin.Calderon@ventura.org or phone (805) 654-2959.

EQUAL EMPLOYMENT OPPORTUNITY: The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.

Agency

Ventura County

Address

800 S. Victoria Avenue
LOC. #1970
Ventura, California, 93009

Phone

(805) 654-5129

Website

http://hr.ventura.org

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