UMass Memorial Medical Center

Credentialing Spec (PD)

UMass Memorial Medical Center  •  Worcester, MA (Onsite)  •  2 days ago
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Job Description

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account.

Exemption Status:

Non-Exempt

Hiring Range:

$19.21 - $34.59

Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations

Schedule Details:

Monday through Friday

Scheduled Hours:

7am-4pm

Shift:

4 - Mixed Shift, 8 Hours (United States of America)

Hours:

0

Cost Center:

99940 - 6612 Medical Staff Admin

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

Performs a variety of duties to obtain, compile, gather, check, arrange, verify and assemble all information and documentation/credentials required for determining the qualifications and clinical competence of medical staff (physicians, dentists, psychologists, podiatrists, dentists, oral surgeons, nurses in expanded roles, physician assistants, social workers, etc.) Prepares documentation for review by the Director, Department Chairs/Division Chiefs and Chief Medical Officer, Residency Program Director, Graduate Medical Education leadership, and by respective committees as applicable.

Performs a variety of duties to prepare applications for practitioners who are applying for privileges at UMass Memorial Medical Center and at any member or affiliate hospitals. Prepares documentation in compliance with shared credentialing agreements established system wide and with other affiliates. Assists applicants in applying for out-of-state licenses as may be required for their duties with UMass Memorial Medical Group.

I. Major Responsibilities:

1. Prepares and distributes applications for appointment and reappointment, using electronic applications whenever feasible. Ensures appropriate authorizations for release of application have been received. Enters, scans and logs all data in Echo.
2. Reviews incoming applications for appointment and reappointment to ensure completeness, check for adverse or questionable information, discrepancies, and that appropriate supporting documentation has been received.
3. Processes queries (electronic or written) for verification of education, training, practice history, malpractice history, licensure, specialty boards, criminal history, sanction and discipline history.
4. Processes queries to National Practitioner Data Bank, American Medical Association Physician Master file, Federation of State Medical Boards, Educational Commission for Foreign Medical Graduates, and American Board of Medical Specialties or equivalent, Office of the Inspector General, Excluded Parties Listing Service, and Criminal Background check. Reviews results for any sanctions, claims, questionable references or information, discipline, criminal history, gaps in education or training, and discrepancies with information provided by applicant.
5. Prepares findings for review and recommendation by chief/chair, Credentials Committee, Medical Staff Executive Committee, and Patient Care Assessment Committee.
6. Prepares applications for UMass Memorial Medical Center practitioners who are seeking appointment/reappointment at member/affiliate hospitals. Works with practitioner and member/affiliate hospital in collection of data, ensuring completeness of information, electronic submission of application data to member/affiliate hospital. Track application through member/affiliate process through completion.
7. Reports all adverse and questionable findings to Director. Obtains additional information as may be requested.
8. Works with clinical department administrators, designees, chief and chairs, and clinical practitioners on issues related to credentialing.
9. Responds to requests from assigned clinical practitioners in providing documentation, answering credentials related questions, serving as a resource in directing practitioners to information on licensure, specialty boards, life support certification, CME opportunities. Providers reminder notices to clinical practitioners regarding documents scheduled for renewal (licensure, prescriptive authority, etc.)
10. Works extensively in Echo credentialing database. Maintains provider information, including demographic information, specific clinical privileges approved, confidential data, licensures, certification, education, training, practice, history, status. Enters, edits, scans, runs reports and letters.
11. Works with extremely sensitive and confidential information.

Standard Staffing Level Responsibilities:

1. Complies with established departmental policies, procedures and objectives.
2. Attends variety of meetings, conferences, seminars as required or directed.
3. Demonstrates use of Quality Improvement in daily operations.
4. Complies with all health and safety regulations and requirements.
5. Respects diverse views and approaches, and contributes in maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
6. Maintains, regular, reliable, and predictable attendance.
7. Performs other similar and related duties as required or directed.

All responsibilities are essential job functions.

II. Position Qualifications:
License/Certification/Education:

Required:
1. High School diploma or equivalency required.
2. National certification as Experience with Microsoft Word and data entry skills required.
Preferred:
1. Associate's degree or certification in business or healthcare related discipline preferred.
2. CPMSM(Certified Professional Medical Services Management) or CPCS (Certified Provider Credentialing Specialist), or willingness to pursue certification is required.

Experience/Skills:

Required:
1. Familiar with legal standards of Credentialing required. Ability to deal with extremely sensitive and confidential information in a professional manner.

Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

III. Physical Demands and Environmental Conditions:

Work is considered sedentary. Position requires work indoors in a normal office environment.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.

UMass Memorial Medical Center

About UMass Memorial Medical Center

The flagship member of the UMass Memorial Health system, UMass Memorial Medical Center is the trusted academic medical center of central Massachusetts and the clinical partner of the UMass Chen Medical School. With over 800 beds (including bassinets) and 7,500 caregivers, UMass Memorial Medical Center is dedicated to ensuring the health and wellbeing of our communities across Central Massachusetts. From delivering around the clock lifesaving care to persevering through a pandemic, our commitment to our communities never wanes. We use knowledge and innovation to deliver breakthrough medicine. To make life better for those we serve. We stand for quality, compassion, dignity, opportunity, and fairness. And we are relentless in our pursuit of healing. UMass Memorial Medical Center includes three campuses located in Worcester, MA:

• Hahnemann Campus

• Memorial Campus

• University Campus

With the latest medical technology and support services, we are the tertiary care referral center for central and western Massachusetts. In addition to being the premier source of academic and clinical excellence in primary care, our care teams feature highly trained specialists who are nationally acclaimed for their expertise and leadership in areas such as:

• Cardiovascular care

• Neurosciences, including the region’s only Joint Commission accredited comprehensive

stroke center

• Orthopedics

• Hematology/oncology

• Liver and kidney transplantation

• Children’s services, as part of the region’s only Children’s Medical Center

• Women’s services

• Pediatric newborn medicine and the region’s only level III Neonatal Intensive Care Unit

• Trauma/emergency medicine and the region’s only designated level I trauma center

• Life Flight, New England’s first hospital-based air ambulance

Comprehensive, Award Winning Care in Central Massachusetts

Industry
Healthcare & Social Services
Company Size
5,001-10,000 employees
Headquarters
Worcester, MA
Year Founded
Unknown
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