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  • Dilsa S. Bailey, CPMSM

Careers in Credentialing



IT WAS SUPPOSED to be a one week temporary assignment at a small hospital in Philadelphia. St. Josesph's Hospital had just merged with Girard Medical Center down the street and was officially known as North Philadelphia Health System. In the year 1991, I walked through those hospital doors without any notion of the turn my life was about to take. One week turned into another and another and another. Before I chose to move on, I had functioned in one role as a multi-functioning employee. I served as credentialing manager, credentialing coordinator, continuing medical education coordinator, emergency room scheduler, facilitator for all medical executive, credentialing, and department meetings, even the Ethics Committee. See why I chose to seek another position? But, it didn't stop there. My roles may have been reduced in other hospitals to fewer committees and just managing the credentialing department, but the demands were just as aggressive, maybe more so. Needless to say, a career in medical services is not for the lighthearted or the weak. Your skin must be tough and knowing how to maneuver the political waters between administration and the medical staff are must have characteristics in hospital settings. It's a job for heavy-lifters, but very rewarding.

The managed care side is not as demanding or as rigorous as the hospitals since privileging, proctoring, and practice evaluations are not included. Managed care does not have the same spikes in application volumes at the end of each residency training year. But, it does have it's own challenges with volumes based on contracts and then making sure all those changes to those contracts haven't left anybody out. Everybody wants to get paid right away whether they have completed the credentialing process or not. Lots of fun. But, now I am being facetious.

The credentialing career is ever changing, but it is a profession that needs the experienced and knowledgeable person at the helm, and the dedicated, eager to learn coordinator in the supporting role. I have been a manager for over 20 years, and a consultant for the last four. It warms my heart to come across individuals that give the profession their all and pains me to see people trying to coast through. This job is very important, coasting can be dangerous to the patients in the hospitals and to the members of those managed care organizations.

Why? A person from outside of healthcare would ask. Though the credentialing process may not be able to gauge whether an individual may eventually cause a patient harm, the process can eliminate those who are known to have done so in the past. Credentialing is a protective shield, as protective as it can humanly be. The credentialing field needs individuals who are willing to know the rules so they can make sure their organizations and the patients/members are safe. Now that I have frightened anyone considering the profession, there are positive upsides. You get to work with some of the most dedicated and focused group of professionals ever, doctors. Who else is willing to go to school for twenty plus years, including grade school, of course. You can earn a decent living and the growth opportunities are very promising, if you are willing to invest by learning as much as you can and implementing it as fast as you can.

These days, I am focusing on training the future's credentialing professionals. Everyday I am working on my new online courses using some of the same techniques I have used with my employees and clients. One day, credentialing may morph into another level, perhaps more nationally conformed, but until then, group practices, locum tenens staffing agencies, hospitals, licensing boards, and managed care organizations are holding onto and supporting their medical services and credentialing staff. Visualize yourself in the credentialing profession. You can do it.

Dilsa S. Bailey, CPMSM is the author and owner of The Right Credentials Network, LLC. Her first online training modules are due for release in the Summer 2016. Join her email distribution list for more information.

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