Credentialing Specialist in Snoqualmie, Washington at Snoqualmie Valley Hospital

At Snoqualmie Valley Health, we’re not just in the business of healthcare; we’re in the business of empowering our community to live boldly and live well. Our commitment to excellence and innovation calls for team members who will build trust, obsess over excellence, lead innovation, and deepen connections within our community. We are guided by our core values, and we’re looking for someone who can embody those principles as part of our dynamic and growing team.

Located in a trailblazing, adventure-loving town at the base of the Cascades, Snoqualmie Valley Health is an independent public hospital district serving a vibrant community that thrives on both adventure and connection. This is more than a job—it’s an opportunity to be part of something bigger.

JOB TITLE: Credentialing Specialist

POSITION SUMMARY: The Credentialing Specialist is responsible for coordinating Medical Staff credentialing and administrative functions that support the Medical Executive Committee and the Medical Staff as a whole. This role manages the operational aspects of credentialing, privileging, meeting preparation, and other Medical Staff processes in accordance with established schedules, policies, regulatory requirements, and applicable laws.

Assignments are planned and carried out with considerable independence. Work is reviewed by administrative leadership through audits, reports, conferences, and adherence to established management guidelines and regulatory standards.

The Credentialing Specialist cross-trains with the Provider Enrollment Specialist to provide backup support for Provider Enrollment functions as needed.

ESSENTIAL FUNCTIONS:

Build Trust: We exhibit integrity, transparency and compassion in every interaction.

• Interpret, explain, and consistently apply regulatory requirements, Medical Staff Bylaws, the Fair Hearing Plan, Rules and Regulations, and applicable policies.

• Maintain accurate and confidential electronic files for Medical Staff members and allied health professionals.

• Ensure Medical Staff quality-management findings are appropriately communicated to designated review committees or departments and maintained in confidential files.

• Maintain systems and records that accurately identify Medical Staff members and their approved clinical privileges.

• Communicate Medical Staff information accurately, appropriately, and timely to relevant departments.

• Ensure documentation of completed orientation and competency requirements is recorded and maintained.

Obsess Over Excellence: We have high standards and seek continuous improvement.

• Administer and execute a comprehensive, specialized credentialing and privileging program that supports continued compliance with CMS requirements and other applicable regulatory and accreditation standards.

• Oversee the credentialing and privileging processes for Medical Staff members, allied health professionals, and other credentialed practitioners.

• Monitor credentialing and privileging processes to ensure applications, verifications, approvals, and renewals are completed accurately and timely.

• Review and revise credentialing and privileging forms, procedures, and supporting documents as needed.

• Prepare and maintain credentialing-related records, reports, rosters, and other required documentation.

• Participate in performance-improvement activities related to credentialing, privileging, Medical Staff operations, and regulatory compliance.

• Monitor departmental processes and recommend improvements that strengthen accuracy, efficiency, and regulatory readiness.

Lead Innovation: We lead with creativity, agility and think bold in our approach.

• Identify opportunities to streamline, standardize, and improve credentialing, privileging, and Medical Staff administrative processes.

• Develop and enhance systems for maintaining, tracking, and distributing practitioner and clinical privilege information.

• Recommend the effective use of technology, space, equipment, staffing, and other resources to support departmental operations.

• Adapt credentialing practices, forms, and workflows in response to changing regulatory requirements, organizational needs, and industry best practices.

• Demonstrate effective leadership in coordinating departmental activities and supporting integration across departments.

Deepen Connections: We build strong relationships with our patients, their families and partners in the communities we serve.

• Work collaboratively with Medical Staff leadership and hospital clinical staff to support the appointment, approval, privileging, and ongoing review of practitioners.

• Partner with practitioners throughout the credentialing process by providing education, application assistance, and administrative support.

• Serve as a knowledgeable resource to practitioners, leaders, and departments regarding credentialing, privileging, and Medical Staff requirements.

• Coordinate intra-departmental activities and promote effective integration and communication between departments.

• Build collaborative relationships that support practitioner readiness, organizational compliance, and safe patient care.Job duties that align with deepening connections.]

QUALIFICATIONS:

Required Education: High School Graduation

Preferred Education: Graduation from an accredited four-year college or university with major course work in business administration or a health care field

Required Licensure: n/a

Preferred Specialty Certification: CPCS, CPMSM or CPES certification required for Credentialing Specialist II

Required Experience: One to three years experience in a health-related field

Skills:

• Ability to communicate effectively and respectfully with people of varied racial, educational and socio-economic backgrounds as well as individuals with disabilities. Skilled in oral, written, and interpersonal communication.

• Expertise in credentialing and provider enrollment terminology. Knowledge of Joint Commission, Center for Medicare & Medicaid services (CMS).

• Advanced computer skills with experience using or the ability to learn organizational and state mandated systems (Symplr, OneHealthPort, PECOs, ProviderOne, CAQH).

• Ability to meet and comply with HIPAA/Confidentiality policies and handled privileged information in a discreet and confidential manner.

• Skilled in time management, proficient in data entry and use of many software applications with strong attention to detail. Ability to manage timeline and critical deadlines.

• Ability to work independently, use critical thinking to set priorities and use good judgement

WORK ENVIRONMENT:

• Work from home or hybrid with good working conditions, clean, well-lighted, air conditioned, heated area.

• Flexibility to work extended hours as needed.

PHYSICAL DEMANDS:

• Sits for long periods at a time.

• Ability to work in a fast-paced environment and handle multiple priorities.

• May require occasional travel between facility locations.

OTHER DUTIES: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

BENEFITS: We believe in taking care of those who take care of our community. We’re proud to offer a comprehensive benefits package that puts your health and well-being first. With our flexible medical plan, you’ll have access to multiple in-network tiers, including top-quality care from Snoqualmie Valley Health, Eastside Health, and First Choice/First Health providers. The best part? Anyone covered under our plan can receive care at SVH at no cost! It's all about giving you the options and support you need to experience life’s great adventures.

• Medical

• Dental

• Vision

• Pharmacy

• Life and AD&D

• Retirement Plan

• Employee Assistance Program (EAP)

• Flexible Spending Account (FSA)

• Travel Assistance & ID Theft Protection

• Pet Insurance

• Other Voluntary Benefits

Benefit Eligibility Requirements - Employees regularly scheduled at least 20 hours per week.

Employee Dependents - Your legal spouse or domestic partner; dependent children until age 26.

Waiting Period - 1st of the month from the date of hire.

PLEASE NOTE:

• The flu shot (during flu season) is required for employment, with exemptions available for valid medical or religious reasons.

• Snoqualmie Valley Health is a drug-free workplace. We complete drug screenings as a part of our onboarding process.