
Hospital & Facility Privileging Specialist
Job Description
- Coordinate initial and reappointment privileging for physicians, APPs, and allied health professionals across assigned facilities.
- Ensure privilege delineation forms are current, accurate, and properly routed for department chair, Credentials Committee, MEC, and Governing Board review.
- Manage FPPE/OPPE processes including tracking requirements, collecting proctoring documentation, and coordinating performance evaluations.
- Manage the intake, review, and completion of applications for credentialing and recredentialing, meeting established SLA timelines.
- Conduct detailed primary source verification for licensure, training, board certification, NPDB, malpractice history, work history, references, and sanctions.
- Maintain ongoing monitoring including license renewals, DEA, and certification expirations.
- Work closely with payer enrollment team to align privileging approval with health plan participation and go‑live dates.
- Ensure compliance with TJC/DNV/HFAP, CMS Conditions of Participation, state board regulations, and organizational medical staff bylaws.
- Maintain accurate electronic files and provider records within credentialing systems.
- Assist with internal and external audits, including surveys and accreditation reviews.
- Protect confidential information in accordance with HIPAA and organizational security policies, including for remote work environments.
- Serve as the primary point of contact for providers regarding application status, expectations, timelines, and required documentation.
- Partner with Medical Staff leadership, HR, Risk Management, Quality, and Legal on complex credentialing or privileging issues.
- Communicate proactively regarding delays, red flags, or barriers to provider start dates.
- Participate in process improvement initiatives such as workflow optimization, electronic form updates, and automation.
- Experience in healthcare administration, credentialing, medical staff services, compliance, legal admin, project coordination, or related field
- 1-2 years of experience in facility privileging and medical staff credentialing within a hospital, ASC, or credentialing office.
- Ability to manage multiple priorities in a hybrid setting with minimal supervision.
- Strong written and verbal communication skills; high attention to detail.
- Takes initiative and problem solves instead of waiting for direction
- Proficient with Microsoft Office/Excel and general data tracking
- Comfortable learning new systems and processes quickly
- Experience with multi‑facility health systems, ASC privileging, or payer enrollment coordination.
- Familiarity with OPPE/FPPE workflows and audit preparation activities.
- Experience working in a hybrid credentialing environment.
- Working knowledge of regulatory and accreditation requirements (TJC, DNV, CMS).
- Experience using credentialing software (MD‑Staff, Cactus/symplr, VerityStream, Medallion, OneApp).
- Regulatory Compliance
- Data Accuracy & Integrity
- Professional Communication
- Workflow & Time Management
- Stakeholder Collaboration
- Process Improvement
- Confidentiality & Security (especially in remote settings)
- Reliable high‑speed internet
- Secure remote workspace compliant with HIPAA standards
- Ability to participate in virtual committee meetings, audits, and team meetings
- Occasional travel to office for in person meetings.
This position offers flexible work options. Occasional on‑site attendance is required for certain meetings or team collaboration sessions.