Credentials Specialist, UC San Diego Health, Hillcrest, San Diego, CA
Posted on June 23rd, 2017
DESCRIPTION
Reporting to the Director of Medical Staff Administration, the Credentials Specialist is responsible for managing the complex analysis, coordination, and monitoring of all physician and allied health practitioner credentialing, assuring compliance with Medical Staff Bylaws, policies, and state and federal accrediting standards. Serves as primary liaison between Medical Administration, applicants, faculty, staff, the Credentials and Medical Staff Executive Committees. Provides advice and guidance on hospital and departmental policies as relates to the credentialing process. Coordinates all credentialing activities to ensure timely submission of applications, privilege requests, and proctoring to appropriate department chairs and sections chiefs, medical staff committees and governing body. , with job standards performed at the EXPERT level.
MINIMUM QUALIFICATIONS
- Certified Provider Credentialing Specialist (CPCS).
- Graduation from college with a major in medical services management, business administration, economics, statistics, educational administration, political science, or an allied field; or an equivalent combination of education and experience.
- Two (2) years in Hospital or Health Plan Credentialing, with comparable administrative analysis experience in a large, complex healthcare environment.
- Skill to use a wide variety of computer software tools, including word processing, spreadsheets, email, internet and database programs to quickly and accurately produce reports, correspondence, presentations, etc.
- Ability to learn new software programs with knowledge of relational databases.
- Effective analytical skills with the ability to assess compliance, record, analyze, and interpret data into meaningful formats.
- Demonstrated ability to use independent judgment and to manage confidential information.
- Proven ability to adapt to changing credentialing needs, adjust pace of work.
- Excellent time management skills with ability to prioritize projects and assignments and manage multiple projects simultaneously.
- Demonstrated ability to work both independently and collaboratively with a team and with multiple departments while being able to take full responsibility for tasks.
- Thorough knowledge of TJC, NCQA, HCQIA, CMS, state and federal regulations related to Medical Staff credentialing, privileging, and licensure.
- Demonstrated ability to be proactive, creative, and innovative in solving problems and issues.
- Demonstrated oral and written communication skills along with exceptional interpersonal skills, proven ability to work across multiple levels of health system and interact with various levels of management, staff, faculty and outside constituents.
PREFERRED QUALIFICATIONS
- Certified Professional In Medical Services Management (CPMSM).
- Three plus years Hospital Medical Staff Credentialing experience.
- Morrisey MSOW
SPECIAL CONDITIONS
Must be able to work various hours and locations based on business needs.
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