This is a description of a Staff Position Classification. It is not an announcement of a position opening. To view descriptions of current openings, please go to UNMJobs and Search Postings to view positions that are currently accepting applications.
The following statements are intended to describe, in broad terms, the general functions and responsibility levels characteristic of positions assigned to this classification. They should not be viewed as an exhaustive list of the specific duties and prerequisites applicable to individual positions that have been so classified.
Summary
Under limited supervision, serves as an essential link and resource between senior management and medical staff to coordinate operational processes and ongoing credentialing, privileging, and medical staff governance functions of the clinical entity's medical staff. Responsible for review, analysis, and follow up of credentialing and privileging applications. Maintains strict confidentiality and ensures compliance with all applicable organizational policies and accrediting and regulatory agencies.
Duties and Responsibilities
Assists in the management of the medical staff support function for the Medical Staff Organization as outlined in the Medical Staff Bylaws.
Coordinates receipt of credentialing and privileging applications following processing and primary source verification by the UNM Health System Credentialing Verification Office (CVO).
Performs review and analysis of practitioner education, training, and experience to determine eligibility for requested privileges.
Reviews, identifies, analyzes, and researches "red flag" items.
Prepares files for review and recommendation by the medical staff.
Coordinates post-committee credentialing process to ensure notification to practitioners, departments, and CVO; database and privileging updates; and completion of files.
Schedules, coordinates, prepares agendas, takes minutes, and provides follow-up for medical staff committees outlined in the Medical Staff Bylaws.
Prepares summary reports of credentialing and/or privileging recommendations and ensures flow of information and action items for medical staff committees outlined in the Medical Staff Bylaws.
Assists in coordination, tracking, and monitoring of the Focused Professional Practice Evaluation process ensuring compliance with regulatory standards and Medical Staff Affairs policies.
Interprets federal, state, local, and government/insurance agency regulations and guidelines, as well as University, Medical Staff Bylaws, rules and regulations, policies and procedures; advises practitioners, management, and administrators on compliance issues as appropriate.
Generates queries and reports from credentialing and privileging database.
Assists with clinical privilege development and maintenance of the privilege database.
Participates as a subject matter expert in developing presentation and orientation materials to stakeholder audiences.
Performs miscellaneous job-related duties as assigned.
Minimum Job Requirements
Successful completion of at least 60 college-level credit hours; at least 3 years of experience directly related to the duties and responsibilities specified. Certification/Licensure NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) or must be eligible and obtain NAMSS CPMSM or CPCS certification within two years from date of hire.
Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.
Knowledge, Skills and Abilities Required
Knowledge of medical staff affairs operational processes.
Knowledge of medical credentialing and privileging procedures and standards.
Knowledge of related accreditation and certification requirements.
Working knowledge of clinical and/or hospital operations and procedures.
Knowledge of clinical privilege criteria development.
Knowledge of medical staff policies, regulations, and bylaws and the legal environment within which they operate.
Information research skills.
Ability to analyze, interpret, and draw inferences from research findings, and prepare reports.
Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community, including executive management and medical staff leadership.
Ability to use independent judgment and to manage and impart confidential information.
Strong oral and written communication skills and the ability to develop and deliver effective presentations.
Database management skills including query and report generation.
Ability to make administrative/procedural decisions and judgments.
Conditions of Employment
Must possess a valid National Association Medical Staff Services (NAMSS) Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS); within two years from date of hire.
Must maintain certification status.
Employees who provide services or work in patient care or clinical areas are required to be in compliance with the University's influenza vaccination requirement.
Working Conditions and Physical Effort
Work is normally performed in a typical interior/office work environment.
No or very limited exposure to physical risk.
No or very limited physical effort required.
The University of New Mexico provides all training required by OSHA to ensure employee safety.
