[Hiring] Provider Credentialing Consultant @University of Utah Health

Role Description

This position is responsible for all aspects of the credentialing process including, but not limited to:

• Ensuring healthcare professionals meet all regulatory requirements.
• Maintaining current information for each provider via the provider database or credentialing system.
• Coordinating with systems team for Epic updates.
• Managing a credentialing workflow to ensure accurate and timely credentialing of new providers and re-credentialing of existing providers.

Responsibilities

• Facilitates monthly credentialing and three-year re-credentialing process for medical and allied health professional staff to ensure compliance with the bylaws and regulatory requirements.
• Implements process improvements as necessary to increase efficiency while ensuring compliance with bylaws and regulatory requirements.
• Participates in annual audits of the credentialing program.
• Maintains all credentialing documentation and provider updates to ensure reliable, efficient retrieval of information by staff.
• Analyzes data between provider database and Epic and reporting discrepancies.
• Maintains data integrity in provider database regarding credentialing information.
• Assists with completion of special projects as requested by various internal departments or in support of requests from regulatory agencies, contracting agencies or other internal/external organizations.
• Exhibits excellent customer relations with office visitors, department coordinators, committee members, coworkers and outside contacts through events such as provider education fairs and seminars.

Qualifications

• Required: Bachelor's Degree in a Healthcare or Business Management or equivalency.
• Required: Two years of related experience.
• Preferred: Certified Provider Credentialing Specialist designation.

Requirements

• Knowledge of appropriate credentialing requirements as well as of government regulations related to the establishment and maintenance of credentialing procedures.
• Ability to perform the essential functions of the job as outlined above.
• Strong oral and written communication skills to effectively communicate with a broad array of internal and external contacts.
• Ability to establish and maintain effective working relationships with providers, management and staff.
• Ability to maintain the confidentiality of all records, discussions and deliberations relating to credentialing, peer review and quality improvement activities.
• Detail oriented with strong organizational and research skills.
• Proficient with spreadsheets and word documents, and preferably Microsoft Access.
• Familiarity with NCQA standards and how to apply them.

Working Conditions and Physical Demands

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects.
• This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

• Listening
• Manual Dexterity
• Sitting
• Speaking
• Standing