Lead Credentialing Specialist

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Humanity in action, Triumph in hardship, Transformation in health.

Department

• Credentialing
  * Oversees and participates in all aspects of credentialing and privileging for initial appointments and reappointments. Processes initial appointments and reappointments for assigned Medical Staff and Advanced Practice Providers in a timely manner and tracks the application from time of receipt to Board approval. The supervisor will not have the same amount of providers to oversee and maintain as the remainder of the Credentialing Specialists/Coordinators, but will keep oversight of all files moving to the approval process.
  * Monitors all incoming privilege packets, applications, and credentialing records for optimal distribution to facilitate timely and accurate retention of documentation. Review and report on all staff and department credentialing and privileging each month.
  (40%)
• Compliance and Auditing
  * Applies working knowledge of the applicable standards, laws, regulations, Medical Staff Bylaws, and Credentialing and Privileging Appointment Policies and Procedures
  * Responsible for the accuracy and integrity of the credentialing and privileging database system, creating uniform and maintainable work loads for all Coordinators and self. Ensuring that tasks are performed to completion with minimal errors and are accurate, thorough, and timely
  * Performs complete file reviews for delegated credentialing audits. Validates that all required credentialing elements are complete and accurate. Provides all necessary documentation for all delegated contracts with insurance companies
  * Audits 1-2 files a week of each Credentialing Specialist/Coordinator, to ensure staff are all following department guidelines and are routine in entry as directed by department leadership
  * Identifies problems or opportunities for improvement, formulates solutions, involve others in the implementation as necessary and required.
  * Applies working knowledge of the applicable standards, laws, regulations, Medical Staff Bylaws, and Credentialing and Privileging Appointment Policies and Procedures.
  (30%)
• Team Oversight
  * Works with the Director of the Department in the oversight and day to day work and questions of the Credentials Specialists/Coordinators of the department.
  * Assists in the training and development of new Specialists/Coordinators to the team
  * Sets clear expectations for staff by developing job specific customer service expectations and behaviors for each position supervised; clearly communicates expectations to each employee and establishes the expectations as job requirements and performance evaluation components; delegates responsibility/authority whenever possible
  (30%)

• No High School Diploma and/or No GED Graduation from High School or equivalent required. Bachelors Preferred Required

• 4-6 years Five years experience in credentialing and privileging for the Medical Staff. Required and
• 1-3 years MD Staff software Experience Required

• Computer proficiency in Windows, Microsoft Office, and Internet
• Knowledge of TJC, NCQA and CMS credentialing standards
• Ability to handle multiple tasks, simultaneously
• Ability to interpret and apply policies and procedures
• Ability to communicate in a professional and positive manner
• Must be able to work independently and meet schedules and deadlines

Shift

Work Type

Salary

Benefits

• Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans

• Free RTD EcoPass (public transportation)

• On-site employee fitness center and wellness classes

• Childcare discount programs & exclusive perks on large brands, travel, and more

• Tuition reimbursement & assistance

• Education & development opportunities including career pathways and coaching

• Professional clinical advancement program & shared governance

• Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program

• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

Our Values

• Respect

• Belonging

• Accountability

• Transparency

All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.

As Colorado's primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).

Denver Health values the unique ideas, talents and contributions reflective of the needs of our community. For more about our commitment to diversity visit: https://www.denverhealth.org/for-professionals/careers/diversity-and-inclusion

Applicants will be considered until the position is filled.