CREDENTIALING MANAGER (100% REMOTE) Job at University of Washington
Benefits:
As a UW employee, you will enjoy generous benefits and work/life programs. For a complete description of our benefits for this position, please visit our website, click here.
As a UW employee, you have a unique opportunity to change lives on our campuses, in our state and around the world. UW employees offer their boundless energy, creative problem-solving skills and dedication to build stronger minds and a healthier world.
UW faculty and staff also enjoy outstanding benefits, professional growth opportunities and unique resources in an environment noted for diversity, intellectual excitement, artistic pursuits and natural beauty.
The University of Washington School of Medicine (SOM) is nationally and internationally recognized for excellent programs in clinical care, teaching, and research activities. The school is part of UW Medicine which includes the University of Washington Medical Center(s) (UWMC), Harborview Medical Center (HMC), and Seattle Cancer Care Alliance.
The University of Washington School of Medicine (SOM) has an outstanding opportunity for a Credentialing Manager to join their team. This is a 100% remote eligible position.
POSITION PURPOSE
The Manager is responsible for managing the operational and personnel activities of the Office of Medical Staff Appointments. The Manager assures that OMSA has a stable operating platform from which to deliver effective and efficient services including the required credentialing and privileging activities for the current 3,990 medical staff members and annual 500 new applicants. The Manager supervises four full time employees, hires staff, evaluate job performance and takes corrective actions if performance is not acceptable. Assures that human resources are managed in accordance with prevailing university policies and procedures.
The Manager leads the following functions which includes but are not limited to:
Manage operating processes and staff resources that support effective and efficient delivery of departmental services.
Manage the appointment and reappointment application process based on practitioner's last name. Assigns and distributes applications to team members. Manage workflows, information systems and policies and procedures to assure that they are current and appropriately maintained.
Manages practitioner notifications to departments, practitioners, Compliance, UAA, UWP and UW Primary Care to ensure compliance with UW Medicine medical staff appointment and privileges.
Assures that all initial and reappointment applications and privileges meet institutional standards for medical staff appointment.
Identifies practitioners whose training and qualifications fall outside of UW Medicine standards and initiates quality assurance review with medical center director, department chair, vice president of medical staff affairs and director of OMSA.
Manage practitioner termination process to ensure compliance with HIPAA and UW Medicine Compliance requirements.
Coordinate with Department Chiefs/Chairs on all department medical staff member’s privileges, appointments, and reappointments.
Collaboratively develops implementation plans that convert strategy to operating tactics.
This position will be required to balance the needs of UW Medicine and University of Washington Physician Network at the same time ensuring compliance with TJC, DOH and NCQA Accreditation Standards and UW Health Systems by-laws.
The Manager is responsible for credentialing/privileging of medical staff and allied health professionals and any related administrative, budgetary, and regulatory duties that impact UW Medicine Hospitals. The Office of Medical Staff Appointments process on average 500 new applicants and 1500 reappointment applications annually. Duties include but are not limited to the following: participation in credentialing/privileging activities, professional liability reviews, participation in meetings, supervision of employees, budget preparation/financial analyses, written/verbal correspondence with external agencies or individuals, continuous quality improvement, and management of the daily operations of Office of Medical Staff Appointments department.
DUTIES AND RESPONSIBILITIES
Medical Services Administration
Maintenance of a complete and accurate record of UW Health Systems facilities review and approval process by collect and compile committee tables, discussions, and actions. Administer management responsibilities as they pertain to medical staff services in accordance with internal and external policies, rules, and regulations. Assisting with budgetary and resource planning needs. Provide a comprehensive instruction and guidance to the UW Health System credentialing and privileging process for practitioners/providers and department medical services staff. Participate in organizational initiatives by providing expertise on medical services topics and advising on accreditation and regulatory issues in order to maintain compliance.
Management of Credentialing Processes
Apply the credentialing process uniformly to all practitioners/providers in accordance with organizational policies in order to address all stakeholder interests. Compile data required for the uniform assessment of practitioners/providers as determined by organizational policy in order to support the evaluation of current competency. Oversee the status of all practitioner/provider expirables (e.g., licenses, certifications, insurances) by querying primary sources in order to validate currency and to ensure ongoing eligibility with the UW Medicine. Verify the absence of sanctions and complaints for all practitioners/providers by researching appropriate sources in order to ensure ongoing eligibility with the organization. Report adverse actions taken against a practitioner/provider by notifying the appropriate authorized agency in accordance with applicable law in order to protect the public.
Privileging
Monitor requested privileges to assure they are uniformly applied to each appointment and reappointment using established criteria based on education, training, and experience in order to ensure current competency. Ensure the applicability and appropriateness of clinical privileges for each specialty through collaboration with Clinical Department Chairs and Medical Director for each facility such as UW Medicine, Harborview Medical Center, and Seattle Cancer Care Alliances.
Process Improvement and Information Management
Manage policies governing the distribution of information in accordance with accreditation, regulatory, and organizational requirements. Participate in the assessment, procurement, implementation, and maintenance of practitioner/provider information systems by communicating the needs of medical service functions in order to manage data with efficiency and integrity. Manage information as it pertains to medical staff services in accordance with confidentiality requirements, using programs (e.g., MSOW, SOMAS, Microsoft Office, EMAIL, and INTERNET)
Manage or 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.
Accreditation and Regulatory Compliance
Serve as the organization’s expert regarding relevant accreditation and regulatory requirements by applying current knowledge of published standards in order to ensure ongoing compliance. Ensure compliance of governance documents (e.g., bylaws, policies, procedures) consistent with current accreditation and regulatory standards in order to ensure quality patient care. Implement a periodic review process for bylaws, policies, and procedures consistent with organizational policy in order to ensure ongoing compliance with accreditation and regulatory requirements such as (e.g., TJC, NCQA, CMS, AAAHC, and URAC).
Risk Management
Maintain and track practitioner/provider performance data, profiles, and Risk Management Compliments/Complaints. Assure inclusion of all practitioner/provider performance data, profiles, and Risk Management Compliments/complaints a as part of reappointment process in order to ensure uniformity, fairness, and quality of patient care.
HR Lead Responsibilities
Collaborate with the Dean of Medicine Human Resources for OMSA, including assisting in development of new positions, interviewing job candidates, selecting, and training new employees, ensuring compliance with established department performance expectations, and evaluating classified staff performances.
MINIMUM REQUIREMENTS
Bachelor's degree in business administration or another relevant field. 4 to 5 years of relevant work experience and 2 years of supervisory experience.
Equivalent education/experience will substitute for all minimum qualifications except when there are legal requirements, such as a license/certification/registration.
ADDITIONAL REQUIREMENTS
Professional certification of CPCS or CPMSM
Experience with demonstrated competence and knowledge of applicable medical staff bylaws, policies & procedures.
Advanced skill in communicating with others, both orally, and in writing, with large and small audiences; preparing reports, monitoring progress, and analyzing data; assisting in budget preparation; ability to administer programs; skill in personnel through coordination and cooperation. Contacts are somewhat unstructured and are frequently with high-level individuals inside and outside the unit including, department heads, regulatory agency representatives; and contacts are to gather data for decision making and problem solving.
Application Process:
The application process for UW positions may include completion of a variety of online assessments to obtain additional information that will be used in the evaluation process. These assessments may include Work Authorization, Cover Letter and/or others. Any assessments that you need to complete will appear on your screen as soon as you select “Apply to this position”. Once you begin an assessment, it must be completed at that time; if you do not complete the assessment, you will be prompted to do so the next time you access your “My Jobs” page. If you select to take it later, it will appear on your "My Jobs" page to take when you are ready. Please note that your application will not be reviewed, and you will not be considered for this position until all required assessments have been completed.
UW faculty and staff also enjoy outstanding benefits, professional growth opportunities and unique resources in an environment noted for diversity, intellectual excitement, artistic pursuits and natural beauty.
The University of Washington School of Medicine (SOM) is nationally and internationally recognized for excellent programs in clinical care, teaching, and research activities. The school is part of UW Medicine which includes the University of Washington Medical Center(s) (UWMC), Harborview Medical Center (HMC), and Seattle Cancer Care Alliance.
The University of Washington School of Medicine (SOM) has an outstanding opportunity for a Credentialing Manager to join their team. This is a 100% remote eligible position.
POSITION PURPOSE
The Manager is responsible for managing the operational and personnel activities of the Office of Medical Staff Appointments. The Manager assures that OMSA has a stable operating platform from which to deliver effective and efficient services including the required credentialing and privileging activities for the current 3,990 medical staff members and annual 500 new applicants. The Manager supervises four full time employees, hires staff, evaluate job performance and takes corrective actions if performance is not acceptable. Assures that human resources are managed in accordance with prevailing university policies and procedures.
The Manager leads the following functions which includes but are not limited to:
This position will be required to balance the needs of UW Medicine and University of Washington Physician Network at the same time ensuring compliance with TJC, DOH and NCQA Accreditation Standards and UW Health Systems by-laws.
The Manager is responsible for credentialing/privileging of medical staff and allied health professionals and any related administrative, budgetary, and regulatory duties that impact UW Medicine Hospitals. The Office of Medical Staff Appointments process on average 500 new applicants and 1500 reappointment applications annually. Duties include but are not limited to the following: participation in credentialing/privileging activities, professional liability reviews, participation in meetings, supervision of employees, budget preparation/financial analyses, written/verbal correspondence with external agencies or individuals, continuous quality improvement, and management of the daily operations of Office of Medical Staff Appointments department.
DUTIES AND RESPONSIBILITIES
Medical Services Administration
Maintenance of a complete and accurate record of UW Health Systems facilities review and approval process by collect and compile committee tables, discussions, and actions. Administer management responsibilities as they pertain to medical staff services in accordance with internal and external policies, rules, and regulations. Assisting with budgetary and resource planning needs. Provide a comprehensive instruction and guidance to the UW Health System credentialing and privileging process for practitioners/providers and department medical services staff. Participate in organizational initiatives by providing expertise on medical services topics and advising on accreditation and regulatory issues in order to maintain compliance.
Management of Credentialing Processes
Apply the credentialing process uniformly to all practitioners/providers in accordance with organizational policies in order to address all stakeholder interests. Compile data required for the uniform assessment of practitioners/providers as determined by organizational policy in order to support the evaluation of current competency. Oversee the status of all practitioner/provider expirables (e.g., licenses, certifications, insurances) by querying primary sources in order to validate currency and to ensure ongoing eligibility with the UW Medicine. Verify the absence of sanctions and complaints for all practitioners/providers by researching appropriate sources in order to ensure ongoing eligibility with the organization. Report adverse actions taken against a practitioner/provider by notifying the appropriate authorized agency in accordance with applicable law in order to protect the public.
Privileging
Monitor requested privileges to assure they are uniformly applied to each appointment and reappointment using established criteria based on education, training, and experience in order to ensure current competency. Ensure the applicability and appropriateness of clinical privileges for each specialty through collaboration with Clinical Department Chairs and Medical Director for each facility such as UW Medicine, Harborview Medical Center, and Seattle Cancer Care Alliances.
Process Improvement and Information Management
Manage policies governing the distribution of information in accordance with accreditation, regulatory, and organizational requirements. Participate in the assessment, procurement, implementation, and maintenance of practitioner/provider information systems by communicating the needs of medical service functions in order to manage data with efficiency and integrity. Manage information as it pertains to medical staff services in accordance with confidentiality requirements, using programs (e.g., MSOW, SOMAS, Microsoft Office, EMAIL, and INTERNET)
Manage or 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.
Accreditation and Regulatory Compliance
Serve as the organization’s expert regarding relevant accreditation and regulatory requirements by applying current knowledge of published standards in order to ensure ongoing compliance. Ensure compliance of governance documents (e.g., bylaws, policies, procedures) consistent with current accreditation and regulatory standards in order to ensure quality patient care. Implement a periodic review process for bylaws, policies, and procedures consistent with organizational policy in order to ensure ongoing compliance with accreditation and regulatory requirements such as (e.g., TJC, NCQA, CMS, AAAHC, and URAC).
Risk Management
Maintain and track practitioner/provider performance data, profiles, and Risk Management Compliments/Complaints. Assure inclusion of all practitioner/provider performance data, profiles, and Risk Management Compliments/complaints a as part of reappointment process in order to ensure uniformity, fairness, and quality of patient care.
HR Lead Responsibilities
Collaborate with the Dean of Medicine Human Resources for OMSA, including assisting in development of new positions, interviewing job candidates, selecting, and training new employees, ensuring compliance with established department performance expectations, and evaluating classified staff performances.
MINIMUM REQUIREMENTS
Equivalent education/experience will substitute for all minimum qualifications except when there are legal requirements, such as a license/certification/registration.
ADDITIONAL REQUIREMENTS
Application Process:
The application process for UW positions may include completion of a variety of online assessments to obtain additional information that will be used in the evaluation process. These assessments may include Work Authorization, Cover Letter and/or others. Any assessments that you need to complete will appear on your screen as soon as you select “Apply to this position”. Once you begin an assessment, it must be completed at that time; if you do not complete the assessment, you will be prompted to do so the next time you access your “My Jobs” page. If you select to take it later, it will appear on your "My Jobs" page to take when you are ready. Please note that your application will not be reviewed, and you will not be considered for this position until all required assessments have been completed.
Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.
Committed to attracting and retaining a diverse staff, the University of Washington will honor your experiences, perspectives and unique identity. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.
The University of Washington is a leader in environmental stewardship & sustainability, and committed to becoming climate neutral.
The University of Washington is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, protected veteran or disabled status, or genetic information.
To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 or dso@uw.edu.
COVID-19 VACCINATION REQUIREMENT
Employees of the University of Washington are required to be fully vaccinated against COVID-19 unless a medical or religious exemption is approved. Being fully vaccinated means that an individual is at least two weeks past their final dose of an authorized COVID-19 vaccine regimen. As a condition of employment, newly hired employees will be required to provide proof of their COVID-19 vaccination. View the Final candidate guide to COVID-19 vaccination requirement webpage for information about the medical or religious exemption process for final candidates.
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