Program Operations Specialist – Credentialing

Job Description

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 Office of Medical Staff Appointments (OMSA) at the School of Medicine has an outstanding opportunity for a Program Operations Specialist - Credentialing.

The Program Operations Specialist Credentialing (Program Operations Specialist) will oversee the operational and personnel activities of OMSA. The individual in this position ensures that OMSA has a stable operating platform from which to deliver effective and efficient services of credentialing and privileging activities for the current medical staff members and new applicants. The Program Operations Specialist job performance is evaluated in terms of independence leadership appropriateness and effectiveness of communications timeliness and accuracy of work knowledge of clinical credentialing regulations and policies and overall progress of OMSA goals.

DUTIES AND RESPONSIBILITIES

Medical Staff Credentialing and Clinical Privileging Operations (60%):
Independently analyze and manage credentialing processes for UW Medicine.
Manage all new eLearning special and additional privileges as requested by provider. Work with eLearning team to analyze and complete special credentialing for Central Venous Catheter Moderate Sedation Fluoroscopy Robotic Surgery and other privileges that require eLearning.
Maintain and analyze clinical privilege forms with the annual review of clinical department chairs and service chiefs. As clinical operations grow and regulations change it is the responsibility of the Program Operations Specialist to ensure the privileging forms are consistent with the needs of the UW Medicine.
This position will be the primary point of contact to ensure credentialing forms are routed through the UW Medicine health system for appropriate clinical approval based upon specialty. This requires the Program Operations Specialist to have a high level of confidentiality clear communication and understanding of the complex health system. This work will be done in coordination with service chiefs and department chairs.
Oversee and manage the process of Short-Term Temporary Privileges for visiting providers. Analyze providers current credentials to ensure UW Medicine credentialing is appropriate and consistent across the system.
Manage Exempt Privileges for providers credentialed for 5 days or less.
Identify and assess proctoring cases to document competency for additional privileges. Collaborate with providers patient care services billing or other clinical operations to collect and ensure proctoring has been completed per clinical policy.
Primary point of contact for Proxy Credentialing for Telemedicine across the WWAMI region. Implement and analyze shared agreements between UW Medicine and other entities.
Oversee Fast Track applications for emergency privileges ensuring each provider is credentialed prior to clinic start date.
Be primary point of contact to medical directors across UW Medicine system to process Disaster Privileges as needed.
Provide oversight and quality assurance to the core processes of Initial and Reappointments applications within OMSA.

Accreditation and Regulatory Compliance (20%):
Act as primary point of contact for Payors Health Plans and OMSA during regulatory audits.
Point of contact for other regulatory accreditation surveys such as the Joint Commission (TJC) and Accreditation Association for Ambulatory Health Care (AAAHC).
Review files selected for compliance to meet audit and regulatory survey requirements.
Respond to documents/records requests in accordance with the regulation.
As an expert attend regulatory survey meetings to respond to survey questions.
Serve as primary point of contact for adverse events reports to NPDB and DOH as requested by Risk Management and Medical Centers. Program Operations Specialist will be expected to communicate directly with providers and senior leadership regarding these reports.

Administration Responsibilities (10%):
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.

Other Duties as Assigned (10%):
Support with budgetary and resource planning needs.

MINIMUM QUALIFICATIONS
Bachelors degree in relevant field and at least two years of credentialing experience.
Certification in NAMSS CPCS or CPMSM or certify within two years of hire.

Equivalent education/experience will substitute for all minimum qualifications except where there are legal requirements such as license/certification/registration.

Additional Qualifications.

Ability to prioritize competing demands to successfully meet deadlines.
Excellent verbal and written communication skills.
Excellent attention to detail with strong interpersonal skills.
Exercise independent judgment of competing priorities.
Strong organizational skills.

Compensation Benefits and Position Details

Pay Range Minimum:

Pay Range Maximum:

Other Compensation:

Benefits:

Temporary or Regular

FTE (Full-Time Equivalent):

Union/Bargaining Unit:

About the UW

Working at the University of Washington provides a unique opportunity to change lives on our campuses in our state and around the world.

UW employees bring their boundless energy creative problem-solving skills and dedication to building stronger minds and a healthier return they enjoy outstanding benefits opportunities for professional growth and the chance to work in an environment known for its diversity intellectual excitement artistic pursuits and natural beauty.

Our Commitment

The University of Washington is committed to fostering an inclusive respectful and welcoming community for all. As an equal opportunity employer the University considers applicants for employment without regard to race color creed religion national origin citizenship sex pregnancy age marital status sexual orientation gender identity or expression genetic information disability or veteran status consistent with UW Executive Order No. 81.

To request disability accommodation in the application process contact the Disability Services Office at or .

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.