Rameza Joaquin

Experience

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  Atlantis Health Plan

  Aug 2004 - Aug 2005

  Credentialing Specialist
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  New York Presbyterian Hospital

  Aug 2005 - Jun 2011

  Credentialing Analyst

  • Managed the initial and reappointment process of all Medical Staff Members, Nurse Practitioners, and Allied Health Care Professionals.• Prepared NPDB and Background checks for prospective and participating Medical Staff Members, Nurse Practitioners, and Allied Health Care Professionals.• Utilized Internet Services in processes related to online credentialing.• Maintained and built reports and letters that are run from the Morrisey credentialing database.• Ensured that all credentialing files are complete and up to date.• Entered all the applicant credentials into the Morrisey credentialing database.• Attended Joint commission compliance meetings.• Assisted the Director with the development and implementation of new processes to improve the efficiency of the office.• Coordinated credentialing procedures with departmental Administrators.• Responded to the New York State codes, rules, and regulations, i.e. providing affiliation hospitals with malpractice, misconduct, new appointments and reappointment information as requested for medical staff members.• Performed audits of credentialing files. Show less

• 

  The Mount Sinai Hospital

  Jun 2011 - Jun 2015

  Credentialing Coordinator II

  • Assisted in all aspects of the credentialing and re-credentialing process for the Medical Staff.• Organized and reviewed applications for completeness and accuracy.• Performed verifications of education, training, experience, certifications, and boards.• Managed relationships with applicants and departments to ensure new and re-appointments are completed within appropriate timeframes• Served as a liaison and led the credentialing process with medical staff personnel, department representatives, licensing agencies and insurance carrier.• Assessed and prioritized Medical Staff appointments and backlog.• Evaluated applicant credentials by hospital medical staff by-laws and other regulatory bodies.• Provided input and feedback to the credentialing specialist in the review/assessment of medical staff privileges.• Assisted in the accurate and timely preparation/organization of files for the monthly Credentials Committee meeting.• Prepared and reviewed folders in preparation for Joint Commission, DOH, CMS, managed care and other audits.• Developed credentialing process metrics to medical staff management and its customers. Show less

• 

  Mount Sinai Health System

  Jun 2015 - Sept 2020

  • Assists with planning and directing the functions of the Medical Staff Services department, including activities related to appointment and reappointment processes. • Leads and manages a team of Credentialing Coordinators and Intake Specialists ensuring that staff is adequately allocated with appropriate resources, to achieve project deliverables and meet client expectations.• Ensures active communication with all external and internal constituencies to establish strong relationships that are complementary and consistent with organizational goals and strategic needs.• Ensures credentials and privileges of all members of the medical and professional staff are in conformance with the hospital staff bylaws rules and regulations, hospital policy and procedure, NY State regulations, Joint Commission, and CMS Standards. • Serves as an operational resource for internal team members for expedited problem identification and resolution, provision of project-specific updates, and team interactions and deadlines. • Manages staff development and training with a focus on productivity and staff retention.• Serve as the expert in the overall scope of the initiative, understanding how the different projects work together to ensure that all staff is working to their full capacity. Reorganized department management of Medical Staff verifications, status changes, and license expirations. Improved efficiencies have led to an increase of external verifications, license expirations, and status changes. Serves as Subject Matter Expert and liaison between the department and the Project Management Office regarding the system-wide Common Credentialing Platform Initiative. The impact has led to successful data mapping of planned data migration to one credentialing database (Cactus Software). Show less • Performed quality review of credentialing performed by coordinators. Ensures quality of credentialing activities, accuracy and organization of files, and accuracy of data in the credentialing database. • Supervised staff during special projects and/or in lieu of leadership availability. • Performed pre-audit of files being submitted to the committee, file reviews for surveys/audits: ensures files comply with hospital and regulatory standards.• Managed all aspects of the credentialing and re-credentialing process for the Medical Staff and Allied Health Professionals.• Managed relationships between clinical department leadership,medical staff leadership, and committee chairpersons.• Monitored industry trends and regulations, Joint Commission for Accreditation of Healthcare Organization (JCAHO) and Center for Medicare and Medicaid Services (CMMS) New York State Department of Health and other regulatory agencies as they pertain to medical staff and allied health professional.• Developed and delivered management process metrics to medical staff management and its customers.• Managed provider privileges within the medical staff services system databases. Show less

  • Manager, Intake Operation (Medical Staff Office)

    Jan 2018 - Sept 2020

  • Credentialing Specialist

    Jun 2015 - Jan 2018
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  Radiology Partners

  Sept 2020 - now

  • Train and manage Training Specialist(s)• Oversee onboarding measurement and evaluation processes of new hires to the CL&P team• Develop protocol and content that will allow for consistent development of training material• Design and maintain effective training programs that align with goals and strategies of the CL&P team• Establish, in partnership with Leadership, departmental performance goals and measures to evaluate the success of training programs• Become an expert on all aspects of CL&P workflows, processes, and policies• Assist in the rollout of new processes/workflows • Manage training schedules, track, and create reports of training times• Market training opportunities to teammates• Support special projects and other duties as requested • Support values of the practice: Integrity, Teamwork, Excellence, Service, and Accountability Show less Responsible for day-to-day onboarding and licensing credentialing operations for Radiology Partners Radiologist and Allied Health Professionals. Leads credentialing coordinators and specialists to ensure each practitioner meets the requirements of the credentialing process and policies of the Practice. Key Contributions:• Oversee, recruit, train, develop and manage on-site and remote teammates. • Responsible for conducting audits and SOP reviews to ensure compliance. • Led a team of Credentialing specialists and Licensing Specialists, ensuring that staff is properly allocated with appropriate resources to achieve project deliverables and meet client expectations.• Create relationships with stakeholders both inside and outside the organizations• Ensures active communication with all external and internal constituencies to establish strong relationships that are complimentary and consistent with organizational goals and strategic needs.• Ensure new Radiologists and new facilities are being credentialed appropriately and timely under the organization accreditation with Joint Commission guidelines. • Develop and ensure compliance with policies, procedures, and best practices. • Develop and implement projects to standardize the facility credentialing process.• Serves as an operational resource for internal team members for expedited problem identification and resolution, provision of project-specific updates, and team interactions and deadlines. • Manages staff development and training, focusing on productivity and staff retention.• Provide updates on credentialing status to Operations and Leadership. Show less

  • Credentialing, Licensing and Privileging Training Supervisor

    Oct 2022 - now

  • Manager, Onboarding and Licensing

    Sept 2020 - Oct 2022