Medical Staff Credentialing Specialist

Presbyterian is seeking a Medical Staff Credentialing Specialist to support the Santa Fe Medical Center.

Supports the Medical and Allied Health Staff credentialing/primary sourcing verification program by coordinating and developing internal processes in order to meet requirements of federal and state regulatory and national accreditation agencies. Monitors timeliness of processes and provides feedback and/or reports to the appropriate manager. Audits accuracy of data entry in the credentialing database and provides feedback to appropriate internal and external customers. This position requires in-depth knowledge of medical and allied health staff credentialing processes and requirements. Investigates issues of concern and conducts follow-up as needed, generates reports and presents findings to the Manager of Medical Staff Affairs (MSA) or Manager of Credentials Verification Organization (CVO). Serves as a subject matter expert to other PHS departments and facilities as it relates to the processing of initial and/or reappointment applications and/or privileging. Responsible for assigned duties and responsibilities to ensure compliance with the Medical Staff Bylaws, Rules/Regulations and/ or the daily work flow of the CVO. Works with the appropriate manager in the development of policies and procedures to meet regulatory and accreditation requirements. Manages special projects as assigned

Type of Opportunity: Full Time
FTE: 1.000000
Exempt: Yes
Work Schedule: Days

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Ideal Candidate:

Associates Degree in medical staff services studies, or a related field preferred. Three to five years experience in medical staff affairs/credentialing, credentials verification organization, or related field preferred.

Associate s Degree/Diploma in medical staff services studies, or a related field preferred.
• Three to five years experience in medical staff affairs/credentialing, credentials verification organization, or related field preferred.
• Public relation skills required in order to be effective and behave in a professional manner when dealing with practitioners and customers.
• Requires excellent time management and organizational skills in order to handle multiple projects simultaneously.
• Certification or eligibility for certification as a Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred.

* High School Diploma or GED

*Assists the Medical Director Department leadership in managing activities to ensure a coordinated effort to fulfill departmental responsibilities within its long-range plans and goals
*Exercises discretion and independent judgment involving the comparison and the evaluation of possible courses of action related to meeting primary source verification and credentialing requirements. Acts or reaches decisions independently after the various possibilities have been considered. * Investigates discrepancies in data submittal related to applications and privileging and formulates appropriate course of action.
*Provides excellent customer service by responding to provider, client, and customer inquiries within specified timeframes, as required by the department
*Maintains statistical information relative to the department s quality indicators
*Responsible for orientation/training of new and current employees as it relates to departmental procedures, credentialing database, and daily work
*Serves as a subject matter expert on appropriate national accreditation agencies and federal/state regulations pertaining to required credentialing processes
*Maintains knowledge base of appropriate national accrediting agencies

We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

Learn more about our employee benefits.

Presbyterian is committed to an inclusive and equitable environment where everyone is valued and empowered for success. We believe that our environment should reflect the diversity of our community.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.

Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
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