UNM Hospital
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CREDENTIALING SPECIALIST
role at
UNM Hospital .
Minimum Offer: $19.28/hr.
Maximum Offer: $23.93/hr.
Department: Provider Network Development.
FTE: 1.00.
Full Time.
Shift: Days.
Position Summary Coordinate, administer, and check all aspects of the credentialing and privileging process for physicians, professional staff providers, and network practitioners within all operational entities of the Health Sciences Center. Initiate and coordinate the reappointment process for existing providers within assigned areas; ensure accuracy and completeness of all documentation; serve as initial point of contact to client faculty and staff on day-to-day credentialing issues. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.
Detailed Responsibilities
CREDENTIALING - Review and screen initial medical staff credentialing applications for completeness, accuracy, and compliance with federal, state, local and University regulations, guidelines, policies, and standards
CREDENTIALING - Perform external research and conduct verification of all applicant licensure, education and training, relevant past employment, and affiliations; assess compliance with risk exposure criteria, and advise management on eligibility for temporary privileges consideration
RESEARCH - Interpret federal, state, local, and government/insurance agency regulation and guidelines, as well as University and Medical Staff Affairs policies for client faculty and staff; advise providers, management, and administrators on compliance issues as appropriate
MEETINGS - Schedule, coordinate agenda for, and facilitate various committees charged with approving credentials and reappointments of medical providers within client areas; provide support and follow up on matters arising from committee meetings
CREDENTIALING - Provide on-site consultations across HSC to credentialing and privileging practices and services; prepare and conduct monthly NCC credentialing committee meeting and provide updates on new policies and procedures
COORDINATION - Interface with providers and students, client departments, internal agencies, and all related external health care agencies on day-to-day credentialing and privileging issues as they arise
ADMINISTRATION - Perform various administrative functions such as monitoring expenditures and preparing reports and correspondence; may participate in a variety of research projects to develop service plans; may propose changes to program policies and procedures
DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
Qualifications Education: High School or GED Equivalent.
Experience: 2 years directly related experience.
Credentials: Not Applicable/Not Required.
Physical Conditions Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
Essential Conditions Working conditions: No or min hazard, physical risk, office environment.
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CREDENTIALING SPECIALIST
role at
UNM Hospital .
Minimum Offer: $19.28/hr.
Maximum Offer: $23.93/hr.
Department: Provider Network Development.
FTE: 1.00.
Full Time.
Shift: Days.
Position Summary Coordinate, administer, and check all aspects of the credentialing and privileging process for physicians, professional staff providers, and network practitioners within all operational entities of the Health Sciences Center. Initiate and coordinate the reappointment process for existing providers within assigned areas; ensure accuracy and completeness of all documentation; serve as initial point of contact to client faculty and staff on day-to-day credentialing issues. Ensure adherence to Hospitals and departmental policies and procedures. No patient care assignment.
Detailed Responsibilities
CREDENTIALING - Review and screen initial medical staff credentialing applications for completeness, accuracy, and compliance with federal, state, local and University regulations, guidelines, policies, and standards
CREDENTIALING - Perform external research and conduct verification of all applicant licensure, education and training, relevant past employment, and affiliations; assess compliance with risk exposure criteria, and advise management on eligibility for temporary privileges consideration
RESEARCH - Interpret federal, state, local, and government/insurance agency regulation and guidelines, as well as University and Medical Staff Affairs policies for client faculty and staff; advise providers, management, and administrators on compliance issues as appropriate
MEETINGS - Schedule, coordinate agenda for, and facilitate various committees charged with approving credentials and reappointments of medical providers within client areas; provide support and follow up on matters arising from committee meetings
CREDENTIALING - Provide on-site consultations across HSC to credentialing and privileging practices and services; prepare and conduct monthly NCC credentialing committee meeting and provide updates on new policies and procedures
COORDINATION - Interface with providers and students, client departments, internal agencies, and all related external health care agencies on day-to-day credentialing and privileging issues as they arise
ADMINISTRATION - Perform various administrative functions such as monitoring expenditures and preparing reports and correspondence; may participate in a variety of research projects to develop service plans; may propose changes to program policies and procedures
DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
Qualifications Education: High School or GED Equivalent.
Experience: 2 years directly related experience.
Credentials: Not Applicable/Not Required.
Physical Conditions Sedentary Work: Exerting up to 10 pounds of force occasionally (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
Essential Conditions Working conditions: No or min hazard, physical risk, office environment.
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