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, oversees the credentialing and privileging operations within UNM Hospital or other clinical entity. Plans, develops, manages, and monitors processes and procedures ensuring quality in conducting, maintaining, and communicating practitioner credentialing and privileging. Serves as the subject matter expert for credentialing and privileging, and collaborates with others to advance the quality of practitioners and patient safety, ensuring ongoing compliance with all applicable accrediting and regulatory agencies. Supervises staff in the day-to-day management of the overall credentialing and privileging functions.
Duties and Responsibilities
Manages and oversees the administrative and daily accreditation, credentialing, and privileging operations for the University's hospital, or other clinical entity, ensuring compliance with university, state, and federal policies and regulations.
Oversees the supervision of personnel, which includes recruitment, work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution; evaluates performance and makes recommendations for personnel actions; mentors employees to achieve peak productivity and performance.
Manages the review and analysis process of credentialing applications following primary source verification, re-privilege, and expansion requests; ensures the credentialing and privileging database is continuously updated and maintained with accurate data; prepares files for review and recommendation by medical staff leadership.
Engages medical staff leadership to facilitate privilege development, maintenance, and regular review of specialty-specific criteria; ensures accurate information is reflected in the privilege database.
Facilitates the organized medical staff committee process with oversight of agenda, minute taking, credentials summary preparation, and committee follow up.
Collaborates with and provides orientation to medical staff leaders to assist them in carrying out functions of the medical staff organization.
Oversees staff to coordinate, track, and monitor the medical staff professional practice evaluation for new privileges process.
Develops and delivers related presentations to stakeholder audiences.
Participates in hospital accreditation and certification surveys, ensuring compliance with medical staff regulatory standards.
Maintains current knowledge of credentialing and privileging rules, regulations, and policies and procedures; manages compliance with accreditation, credentialing and privilege standards and regulatory requirements.
Assists in establishing and implementing short- and long-range goals, objectives, policies, and operating procedures.
Reviews and ensures accurate completion and timely submission of governmental, University, and other reports as required, with respect to assigned areas of responsibilities.
Performs miscellaneous job-related duties as assigned.
Minimum Job Requirements
Successful completion of at least 60 college-level credit hours; at least 5 years of experience directly related to the duties and responsibilities specified. Certification/Licensure: NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM).
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 clinical privilege criteria development.
Extensive knowledge of related accreditation requirements.
Extensive knowledge of medical credentialing and privileging procedures and standards.
Extensive knowledge of medical staff policies, regulations, and bylaws and the legal environment within which they operate.
Working knowledge of clinical and/or hospital operations and procedures.
Skill in examining and re-engineering operations and procedures, formulating policy, and developing and implementing new strategies and procedures.
Skill in organizing resources and establishing priorities.
Ability to make administrative/procedural decisions and judgments.
Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments.
Ability to foster a cooperative work environment.
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.
Strong oral and written communication skills and the ability to develop and deliver effective presentations.
Database management skills to include credentialing software, with ability to organize information and data to identify/explain trends.
Exhibits confidence and professional diplomacy.
Demonstrates an understanding of concepts, key functions, terminology, and work products of risk management, human resources, clinical competence evaluation, legal, information technology, and performance improvement.
Conditions of Employment
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
No or very limited exposure to physical risk.
No or very limited physical effort required.
Work is normally performed in a typical interior/office work environment.
The University of New Mexico provides all training required by OSHA to ensure employee safety.
