About The Position

Incumbent is an experienced professional who applies credentialing theory, knowledge, and in-depth understanding of the field to perform a full range of responsibilities within this role. This individual is responsible for assisting in the development, implementation, and monitoring of credentialing processes and procedures required by the Medical Staff bylaws, state and federal laws, hospital accreditation, and NCQA standards. Credentials practitioners, maintains accurate physician data, coordinates Medical and/or University Physicians and Surgeons (UPS) staff meetings, prepares a variety of reports and prepares policies and procedures to meet licensing requirements. Provides suggestions for improvements in department credentialing and licensure and serves as a liaison between the medical staff and all departments to provide overall continuity. Incumbent provides other general administrative support to the department as needed or assigned.

Requirements

  • Thorough knowledge of data management and documentation methods used in medical credentialing
  • Strong interpersonal and organizational skills
  • Strong analytical and problem solving skills and the ability to think critically and provide workable solutions
  • Proficient in Microsoft Office, Word, PowerPoint, Excel and Outlook
  • Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
  • Must demonstrate customer service skills appropriate to the job
  • Must become CPMSM and/or CPCS certified within 12 months of employment
  • Minimum of two (2) years relevant credentialing experience
  • Knowledge of the Joint Commission and NCQA standards, California Code of Regulations Title 22 and CMS regulations regarding Conditions of Participation
  • Excellent written and verbal communication skills in English
  • Demonstrated understanding of medical terminology
  • Bachelor's degree in related area and / or equivalent experience / training
  • Ability to use sound judgment in ambiguous situations and effectively manage change
  • Ability to maintain a work pace appropriate to the workload
  • Ability to independently set and meet deadlines, multi-task, and effectively manage competing priorities
  • Ability to establish and maintain effective working relationships across the Health System
  • Ability to coordinate and resolve issues in a timely manner
  • Ability to complete job responsibilities accurately with limited supervision and oversight

Nice To Haves

  • Knowledge of University and medical center organizations, policies, procedures and forms
  • Current NAMSS certification as CPCS and/or CPMSM

Responsibilities

  • Assisting in the development, implementation, and monitoring of credentialing processes and procedures required by the Medical Staff bylaws, state and federal laws, hospital accreditation, and NCQA standards.
  • Credentials practitioners
  • Maintains accurate physician data
  • Coordinates Medical and/or University Physicians and Surgeons (UPS) staff meetings
  • Prepares a variety of reports and prepares policies and procedures to meet licensing requirements.
  • Provides suggestions for improvements in department credentialing and licensure and serves as a liaison between the medical staff and all departments to provide overall continuity.
  • Provides other general administrative support to the department as needed or assigned.

Benefits

  • We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks.
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