Supervisor Enterprise Credentialing: Enterprise Credentialing

Job DescriptionPrimary Duties and ResponsibilitiesUnder the direction of the Executive Director of Enterprise Medical Staff Services and Credentialing (EMSSC), the Supervisor is responsible for leading, coordinating, monitoring, and maintaining processes and related functions. Ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to NCQA standards. Coordinates to manage the functions required to conduct credentialing and privileging activities of the medical staff organization and ensures that the credentialing and privileging activities of the medical staff organization are timely and meet all internal requirements (bylaws, rules and regulations, policies and procedures) while ensuring compliance with external accreditation standards, state laws and Medicare Conditions of Participation. Duties may include, but are not limited to process supervision, application management, verification of credentials, file maintenance (electronic), expirables management, information management, focused review, and direct support of the evaluation and decision-making process.Enterprise Credentialing onlyThis position assists the Executive Director in developing reports for submission to healthcare plans and other regulatory and accrediting bodies.Medical Staff Office onlyOversees all functions related to medical staff services, including meeting management, performance monitoring and practitioner competency management. This position assists the EMSSC in developing reports for meetings, including the credentials report for presentation to the Credentials Committee, Medical Executive Committee and Board of Directors.QualificationsEducation and ExperienceHigh School diploma, GED, California High Proficiency or equivalent work experienceProficiency with Microsoft Office Products (Word, Excel, PowerPoint)Experience specific to NCQA standardsCredentialing database managementPreferred2 years of lead or supervisory experience in Medical Staff/Credentialing Services in an acute care settingAssociate’s Degree in a healthcare management related major1+ years of experience with MD Staff, including use of MD-AppLicense RequiredN/ALicense PreferredN/ACertifications RequiredN/ACertifications PreferredCertified Professional Credentialing Analyst (CPCS)Certified Professional Medical Services Professional (CPMSM)About UsHoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/ .Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.