Credentialing Specialist

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

This position is responsible for coordinating and implementing activities related to the credentialing and privileging of initial applicants and reappointment applicants of the Medical and Allied Health Professional Staff of the University of Utah Health Care in accordance with the Medical Staff Bylaws, applicable regulatory requirements and accreditation standards. This position is not responsible for providing care to patients.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Responsibilities

• Facilitates monthly credentialing for medical and allied health professional staff to ensure compliance with the Medical Staff Bylaws, Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), URAC, as well as State regulatory requirements and all other accreditation requirements.

• Facilitates the reappointment process for medical and allied health professional staff every two years to ensure compliance with the Medical Staff bylaws, regulatory standards and accreditation standards.

• Supports the activities of the Credentials Committee, the Interdisciplinary Credentials Committee and the Medical Board.

• Ensures compliance with Medical Staff Bylaws, departmental policies and procedures, regulatory requirements and accreditation standards.

• Ensures that expiring documents are tracked, practitioners notified 30 to 60 days in advance, and renewal copies obtained before expiration.

• Ensures compliance with UUMG delegated credentialing contracts in accordance with regulatory requirements and accreditation standards.

• Communicates appropriately with others so that day-to-day operations are facilitated.

• Exhibits excellent customer relations with office visitors, department coordinators, physicians, allied health professionals, committee members, coworkers and outside contacts in support of the exceptional patient experience.

• Demonstrates the ability to perform job duties incorporating knowledge of age and cultural differences to ensure that the credentialing and privileging process is administered fairly across the applicant population.

Knowledge / Skills / Abilities

• Demonstrated potential ability to perform the essential functions as outlined above.

• Demonstrated human relations, customer service, organization and effective communication skills.

• Heightened attention to detail.

• Ability to simultaneously facilitate multiple priorities efficiently and effectively.

• Ability to work consistently with frequent interruption.

• Knowledge of business telephone etiquette.

• Demonstrated database systems management skills.

• Ability to utilize word processing and spreadsheet software effectively.

• Knowledge of regulatory requirements and accreditation standards.

• Technical clerical skills.

• Ability to communicate diplomatically with applicants, department coordinators, division chiefs, department chairs and others.

Qualifications

Qualifications

Required

• Associates degree in a related area of assignment or equivalency.

• Three years experience as professional support in a medical field, preferably in the medical staff services field.

• Certified Provider Credentialing Specialist certification or ability to become certified within three years of hire.

Qualifications (Preferred)

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Color Determination, Listening, Manual Dexterity, Sitting, Speaking, Standing