Hybrid MED STF SVC SPEC 2 at University of California, San Francisco
University of California, San Francisco · San Francisco, United States Of America · Hybrid
- Professional
- Office in San Francisco
Job Summary
Key Responsibilities:
Cultivate and produce efficient and compliant onboarding processes, including:
- Pre-application intake and monitoring
- Application/enrollment submission and data analysis
- Reappointment/revalidation and related competency assessments (FPPE/OPPE)
- Auditing and quality review of credentialing program
- Discrepancies/flagged items requiring additional comment/consideration
- Board Actions, temporary/visiting privileges
Generate health plan enrollment applications, tracking reports, and ensure enrollment into web-based systems for government payors.
Serve as a functional expert for Credentials Committee, Committee on Interdisciplinary Practice (CIDP), and/or CVO clients.
Collaborate with department chairs regarding scope of practice and new privileges within clinical services/programs.
Prepare agendas, minutes, reports, presentations, correspondence, emails, scheduling, and logistics for committees/CVO clients' functional responsibilities and delegated credentialing agreements.
Research and resolve disruptions to revenue channels due to medical staff data integrity.
Partner with department leaders to ensure alignment with onboarding priorities and optimize patient access to qualified providers.
Establish priorities and initiate temporary privileges to resolve and align patient access within organizational work plans/priorities.
Initiate procedures and leadership communication to administratively suspend/reinstate provider's status and clinical access to patient services.
Draft action plans for leadership approval/recommendation and monitor actions through reinstatement to ensure compliant resolution.
Facilitate and lead quality/process improvement projects as assigned, such as:
- Desktop procedures
- New privilege implementation
- Data integrity
- Workflow development
- Training/education
- Storage/archive digital documentation or other initiatives per department goals/initiatives.
For roles covered by a bargaining unit agreement, there will be specific rules about where a new hire would be placed on the range.
To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html
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Required Qualifications
Knowledge of TJC, NCQA, CMS, DHS, DMHC, ACGME, and other applicable accreditation/regulatory requirements.
Competency in a paperless computer environment and understanding of provider data integrity standards (credentialing software, MS Office suite, Adobe Professional, document scanning/storage, web-based applications and tools, etc.).
Excellent ability to interact with all levels of management, communicate effectively, both verbally and in writing, and function within a team and independently.
Ability to perform all commonly applicable functions in Microsoft Office Suite (Word, Excel, PowerPoint) and medical credentialing database application.
Data analysis, research, and reporting skills.
Exceptional organizational skills and ability to set priorities as well as manage multiple demands effectively.
Role model and promote best practices to maintain confidentiality and discretion to preserve HIPAA/Peer review protections as well as attorney-client privilege, as warranted.
Knowledge of compliant revenue/billing practices to mitigate fraud/waste/abuse impacts on organization priorities/work plans.
Bachelor's degree in a related area and/or equivalent experience/training.
Preferred Qualifications
Three years in a healthcare environment with emphasis in medical staff operations, academic medical centers, and/or provider credentialing for third-party payors and health plans preferred.
Certified Provider Credentialing Specialist (CPCS) within 18 months of hire from OMAG required to meet performance expectations of the role.
Certified Professional Medical Services Management (CPMSM).
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Equal Employment Opportunity
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About UCSF
Pride Values
In addition to our PRIDE values, UCSF is committed to equity – both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at diversity.ucsf.edu
Join us to find a rewarding career contributing to improving healthcare worldwide.
