Program Operations Specialist – Credentialing

University of Washington Medical Center•Seattle, WA

1d•Onsite

About The Position

The Office of Medical Staff Appointments (OMSA) at the School of Medicine has an outstanding opportunity for a Program Operations Specialist - Credentialing. The Program Operations Specialist – Credentialing (Program Operations Specialist) will oversee the operational and personnel activities of OMSA. The individual in this position ensures that OMSA has a stable operating platform from which to deliver effective and efficient services of credentialing and privileging activities for the current medical staff members and new applicants. The Program Operations Specialist job performance is evaluated in terms of independence, leadership, appropriateness and effectiveness of communications, timeliness and accuracy of work, knowledge of clinical credentialing regulations and policies, and overall progress of OMSA goals.

Requirements

Bachelor’s degree in relevant field and at least two years of credentialing experience.
Certification in NAMSS CPCS or CPMSM or certify within two years of hire.
Ability to prioritize competing demands to successfully meet deadlines.
Excellent verbal and written communication skills.
Excellent attention to detail with strong interpersonal skills.
Exercise independent judgment of competing priorities.
Strong organizational skills.

Nice To Haves

Equivalent education/experience will substitute for all minimum qualifications except where there are legal requirements such as license/certification/registration.

Responsibilities

Independently analyze and manage credentialing processes for UW Medicine.
Manage all new eLearning special and additional privileges as requested by provider. Work with eLearning team to analyze and complete special credentialing for Central Venous Catheter, Moderate Sedation, Fluoroscopy, Robotic Surgery, and other privileges that require eLearning.
Maintain and analyze clinical privilege forms with the annual review of clinical department chairs and service chiefs. As clinical operations grow and regulations change, it is the responsibility of the Program Operations Specialist to ensure the privileging forms are consistent with the needs of the UW Medicine.
This position will be the primary point of contact to ensure credentialing forms are routed through the UW Medicine health system for appropriate clinical approval based upon specialty. This requires the Program Operations Specialist to have a high level of confidentiality, clear communication and understanding of the complex health system. This work will be done in coordination with service chiefs and department chairs.
Oversee and manage the process of Short-Term Temporary Privileges for visiting providers. Analyze providers current credentials to ensure UW Medicine credentialing is appropriate and consistent across the system.
Manage Exempt Privileges for providers credentialed for 5 days or less.
Identify and assess proctoring cases to document competency for additional privileges. Collaborate with providers, patient care services, billing or other clinical operations to collect and ensure proctoring has been completed per clinical policy.
Primary point of contact for Proxy Credentialing for Telemedicine across the WWAMI region. Implement and analyze shared agreements between UW Medicine and other entities.
Oversee Fast Track applications for emergency privileges, ensuring each provider is credentialed prior to clinic start date.
Be primary point of contact to medical directors across UW Medicine system, to process Disaster Privileges as needed.
Provide oversight and quality assurance to the core processes of Initial and Reappointments applications within OMSA.
Act as primary point of contact for Payors, Health Plans and OMSA during regulatory audits.
Point of contact for other regulatory accreditation surveys such as the Joint Commission (TJC) and Accreditation Association for Ambulatory Health Care (AAAHC).
Review files selected for compliance to meet audit and regulatory survey requirements.
Respond to documents/records requests in accordance with the regulation.
As an expert, attend regulatory survey meetings to respond to survey questions.
Serve as primary point of contact for adverse events reports to NPDB and DOH, as requested by Risk Management and Medical Centers. Program Operations Specialist will be expected to communicate directly with providers and senior leadership regarding these reports.
Lead departmental process improvement projects. Measure and report all cost savings and increase efficiency in departmental processes.
Lead and participate in work groups to evaluate and implement continuous improvement and application of lean methodology for rapid improvement.
Manage and increase teamwork across all improvement efforts, training and building team skills where appropriate for successful implementation of Lean.
Maintenance of a complete and accurate record of UW Medicine facilities review and process by collecting and compiling committee tables, discussions and actions.
Work with leadership to create and distribute regular communications or e-blasts to clinical departments.
Support with budgetary and resource planning needs.