Health System Specialist - Credentialing and Privileging Specialist

Department of Veterans Affairs•Saginaw, MI

39d•Hybrid

About The Position

The Medical Staff Office is responsible for the Credentialing and Privileging (C&P) process of VAMC clinical services providers, including full-time, part-time, temporary, intermittent, contract, without compensation (WOC), fee basis, and telehealth Licensed Independent Providers (LIPs), as defined in the VAMC Medical Staff Bylaws. Duties include but not limited to: Program Analysis and Support - 25% Assists the Credentialing and Privileging (C&P) Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations The incumbent ensures accurate provider data is entered into and maintained in the VetPro computer program. The incumbent holds the credit card and is responsible for maintaining records, reconciling monthly charge statements and verifying legitimacy of requests for National Practitioner Data Bank - Continuous Query (NPDB-CQ) enrollments/ renewals, licensure verification (if applicable), Educational Commission for Foreign Medical Graduates, American Medical Association, Federation of State Medical Boards (FSMB), National Student Clearing House, Work Number and, board certification (if applicable). Compliance - 25% Manages provider applications (initial and renewals) for Licensed Independent Practitioners (LIPs) C&P within the Medical Center. Provides guidance and instruction to hospital staff in completing the required documentation for establishing privileges for LIPs Quality Assurance - 25% Ensures that application packages and other documents meet the technical requirements specific to the provider's specialty and verifies that the application folder and database account (VetPro or other internal databases and spreadsheets) comply with these requirements. Communicates with LIPs to assure timely completion of applications and VetPro requirements Coordinates incoming data from a variety of sources; establishes protocols for incoming data; organizes computerized data sets; and retrieves computerized data Participates in the required annual C&P self-assessment and, if opportunities for improvement are identified, is involved in efforts to implement these improvements. Program Advisor - 25% Serves as technical advisor to the Executive Committee of the Medical Staff (ECMS) and, if applicable, the Credentials Committee Refers to current issues, trends, problem areas, as well as recommended program revisions to Credentials and Privileging functions through the C&P Manager/Analyst. Prepares agendas for credential-related meetings, ensures those involved are notified of expectations, and ensures that all necessary paperwork is completed and accurately prepared for committee action Conducts final appointment into the VetPro database, after thoroughly researching, analyzing, and validating all data, information, documents, and signature authorities Develops and provides routine and special reports as requested by the C&P Manager/Analyst. Composes correspondence requiring Clinical Service Chiefs, Chief of Staff, and Medical Center Director signatures for privileging actions

Responsibilities

Assists the Credentialing and Privileging (C&P) Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program
Assists C&P Manager/Analyst in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations
Ensures accurate provider data is entered into and maintained in the VetPro computer program.
Maintains records, reconciling monthly charge statements and verifying legitimacy of requests for National Practitioner Data Bank - Continuous Query (NPDB-CQ) enrollments/ renewals, licensure verification (if applicable), Educational Commission for Foreign Medical Graduates, American Medical Association, Federation of State Medical Boards (FSMB), National Student Clearing House, Work Number and, board certification (if applicable).
Manages provider applications (initial and renewals) for Licensed Independent Practitioners (LIPs) C&P within the Medical Center.
Provides guidance and instruction to hospital staff in completing the required documentation for establishing privileges for LIPs
Ensures that application packages and other documents meet the technical requirements specific to the provider's specialty and verifies that the application folder and database account (VetPro or other internal databases and spreadsheets) comply with these requirements.
Communicates with LIPs to assure timely completion of applications and VetPro requirements
Coordinates incoming data from a variety of sources; establishes protocols for incoming data; organizes computerized data sets; and retrieves computerized data
Participates in the required annual C&P self-assessment and, if opportunities for improvement are identified, is involved in efforts to implement these improvements.
Serves as technical advisor to the Executive Committee of the Medical Staff (ECMS) and, if applicable, the Credentials Committee
Refers to current issues, trends, problem areas, as well as recommended program revisions to Credentials and Privileging functions through the C&P Manager/Analyst.
Prepares agendas for credential-related meetings, ensures those involved are notified of expectations, and ensures that all necessary paperwork is completed and accurately prepared for committee action
Conducts final appointment into the VetPro database, after thoroughly researching, analyzing, and validating all data, information, documents, and signature authorities
Develops and provides routine and special reports as requested by the C&P Manager/Analyst.
Composes correspondence requiring Clinical Service Chiefs, Chief of Staff, and Medical Center Director signatures for privileging actions