Credentialing Manager Jobs

About The Position

Requirements

• One year of specialized experience equivalent to at least GS-9 in the normal line of progression, such as serving as a technical advisor on credentialing and privileging, overseeing C&P activities, analyzing program data and audit findings, conducting quality and compliance oversight, and presenting findings and recommendations to leadership and committees.
• Alternatively, a Ph.D. or equivalent doctoral degree, three full years of progressively higher-level graduate education leading to such a degree, or a related LL.M. may substitute for experience; a combination of specialized experience and qualifying graduate education may also be used.
• Current federal employees and certain former federal employees applying for a GS-11 position must meet the time-in-grade requirement of 52 weeks at GS-9 and submit supporting SF-50 documentation.
• U.S. citizenship is required.
• Complete the application, questionnaire, and required online assessment.
• Male applicants born after December 31, 1959, must be registered with Selective Service.
• Selected applicants are subject to a background/security investigation and online onboarding; acceptable identification is required for pre-employment requirements.
• Participation in the seasonal influenza vaccination program is required for VA Health Care Personnel.
• A one-year probationary period or two-year trial period may be required.
• Submit a transcript if qualifying in whole or in part based on education; foreign education requires a Certificate of Foreign Equivalency with the transcript.

Nice To Haves

• Supervisory experience, including performance reviews and staff training.
• Two years of experience with VHA Credentialing and Privileging processes.
• Quality and compliance oversight experience.
• Knowledge of principles and practices supporting an effective C&P program.
• Experience with OPPE and FPPE review, monitoring, and compliance reporting.
• Knowledge of Human Resources processes and regulations related to C&P.
• One year of office administrative or credentialing experience.
• Proficiency with Microsoft Excel, Adobe, and other standard office software applications.
• Strong organizational skills and experience supporting accreditation activities.
• Knowledge of applicable Joint Commission (JC), OIG, VHA, and regulatory requirements.

Responsibilities

• Plan and assign work for C&P employees, establish priorities, assess staffing needs, evaluate performance, provide feedback and counseling, approve leave, address employee issues, and participate in recruitment and selection.
• Provide authoritative guidance to facility leadership, Service Chiefs, providers, C&P staff, Human Resources, and other stakeholders on credentialing and privileging requirements, policies, regulations, and standards.
• Oversee and review initial and recredentialing actions, clinical privileges and scopes of practice, FPPE/OPPE, adverse privileging actions, malpractice and risk-management matters, primary-source verification, and related committee actions.
• Monitor and audit the facility C&P Program using VetPro and other required reporting and auditing tools to ensure compliance, data accuracy, timely completion, and adherence to national, VISN, regulatory, and accreditation requirements.
• Analyze program data, audit findings, report cards, trends, vulnerabilities, and regulatory requirements; develop recommendations, corrective-action plans, risk-mitigation strategies, and process improvements.
• Prepare and present C&P information, findings, trends, recommendations, and required reports to facility leadership and committees, including the Medical Executive Committee and other quality, safety, and health care delivery committees.
• Coordinate and represent the C&P Program with Human Resources, Service Chiefs, VISN leadership, regulatory and accrediting organizations, auditors, the Office of General Counsel, Contracting, telehealth staff, licensing boards, and other stakeholders.
• Identify staff development and training needs and provide or arrange training, mentoring, coaching, and succession-planning activities.
• Administer facility-level C&P accounts and reporting functions, including NPDB, Federation of State Medical Boards, Our Providers, and VetPro access and certification activities; ensure required queries, adverse-action reports, enrollments, reviews, certifications, and corrective actions are completed accurately and on time.

Benefits

• Federal employee benefits package for employees and their families; specific benefits depend on position type and eligibility.