Credentialing is the intake, vetting, and adjudication of professionals to check education, licensing, certifications, etc. These artifacts are attached to a person through a case and once adjudicated, afford the employee or contractor certain privileges (e.g. patient care, medical practice, information security, law enforcement, etc.). Credentialing activity reviews occur initially during the onboarding process, but continuous evaluation occurs throughout the professional’s tenure at an agency.

Similar to the new continuous evaluation program in the personnel security domain, credential holders also should be monitored and evaluated throughout their tenure. The privileges held by credential holders convey responsibility and trust but unfortunately, adverse events occasionally occur. The reporting of adverse events may occur through self-reporting, customer/employee complaint, through the personnel security evaluation process, or other means. The collection and adjudication of these reports need to be handled by the appropriate staff in the credentialing office and the tracking of these events can be handled through a discrete workflow but will always be associated with the credential holder’s parent case. This powerful association ensures the event is associated with the credential holder and the adjudication of the event will be associated with the overarching credential management case which eliminates the need for an integration with a separate system. As an example, let us consider the report of a medical malpractice claim for a federal healthcare provider. Since this claim could become a potentially compensable event, the report, investigation, and adjudication must be handled with great rigor. Privileges could be curtailed or suspended (depending on the severity) until the matter is adjudicated.

All healthcare organizations must verify the credentials of every healthcare provider who works — and wants to work — for them. In doing so, they ensure that the providers are qualified and competent, and that the organizations are following regulations. For years, professionals have performed credentialing work through endless paper forms, spreadsheets, and emails. But increasingly, credentialing software is helping organizations do that work more efficiently and effectively. Contact us at [email protected] to show how you can leverage a modern low-code platform like ServiceNow to provide the tools required to modernize your credential management process for any discipline.