Credentialing Program Assistant

U.S. Department of Veterans Affairs; Columbia Township (MO); On-site; USD 45,000 - 60,000; Full time

Job summary

U.S. Department of Veterans Affairs is seeking a Credentialing Program Assistant to support the Credentialing and Privileging program at the Harry S Truman VA Medical Center in Columbia, MO.

The role focuses on accurate provider data, vetpro-based credentialing, and adherence to regulatory standards. The incumbent assists the C&P Manager, reviews NPDB and FSMB records, and coordinates with clinical departments to ensure credentialing readiness.

Qualifications

• Experience with credentialing or privileging processes.
• Familiarity with primary source verification (state licenses, DEA, board certifications).
• Experience with credentialing software such as VetPro or similar systems.
• Knowledge of regulatory standards (TJC/VHA) related to credentialing.

Responsibilities

• Assist C&P Manager/Analyst in developing goals for the credentialing program.
• Review VetPro reports to identify problem areas needing investigation.
• Enter and maintain provider data in VetPro, including licensure and certifications.
• Manage initial credentialing applications for non-LIPs; perform primary source verification.
• Provide guidance to hospital staff on credentialing documentation.
• Participate in annual C&P self-assessment and regulatory reviews.
• Perform other duties as assigned.
• Work schedule: Monday - Friday, 8:00am - 4:30pm.

Skills

Credentialing knowledge

VetPro

Primary source verification

Regulatory awareness

Tools

VetPro

NPDB CQ

FSMB data

Job description

The Credentialing Program Assistant is assigned to the Chief of Staff office within Harry S Truman VA Medical Center and is responsible for providing administrative and technical work and support to the credentialing operations in Columbia, MO.

Duties

Duties include, but may not be limited to the following: Credentialing Duties (100%)

The incumbent assists the Credentialing and Privileging (C&P) Manager/Analyst in developing short- and long-term goals necessary to accomplish the mission of the C&P program. Assists in identifying the resources necessary for accomplishing the mission and function of the credentials program. Serves as SME in the field of credentials.

Receives and reviews correspondence and communications for the C&P function and determines which items require immediate attention and which are confidential in nature. Receives and reviews VetPro reports detecting problem areas requiring further investigation. Upon identification of a problem, researches reference materials, regulations, and standards to identify appropriate action necessary to correct the problem. Issues of a serious nature are elevated to the supervisor for guidance.

Ensures accurate provider data is entered into and maintained in the VetPro computer program. Ensures current information is present on providers relative to state licensure, Drug Enforcement Organization (DEA) license, National Practitioner Data Bank (NPDB) Continuous Query (CQ) enrollments and renewals, Federation of State Medical Boards (FSMB), documentation of professional education, specialty medical training, certifications, initial credentialing. Informs C&P Manager/Analyst of trends identified, audit results and identified problems that may affect a provider's credentialing status.

Manages provider applications (initial) for non-LIPs within the VAMC. Incumbent must have a general knowledge of medical specialties.

Provides guidance and instruction to hospital staff in completing the required documentation of establishing credentialing for non-LIPs. Upon receipt of individual credentials' files for review, incumbent ensures primary source verification to include, but not limited to, state licenses, DEA license, certifications, medical specialty training, and board certifications. Primary source verification includes, but may not be limited to, the American Medical Association, NPDB, state licensing agencies, specialty certification boards, universities, DoD and healthcare facilities. Coordinates with clinical service departments on findings of clinical care competency.

Participates in the required annual C&P self-assessment and if opportunities for improvement are identified, is involved in improvement efforts. Provides ongoing review of regulatory requirements, TJC Standards, changing laws and legal precedents to review hospital regulations and make necessary recommendations for changes to ensure compliance with current VHA, and, TJC Standards and in the event of an emergency declaration. Reviews quality assessment findings, risk management evaluations and malpractice claim actions to ensure appropriate coordination regarding individual provider clinical suitability.

Performs other duties within the C&P program as assigned.

Work Schedule: Monday - Friday, 8:00am - 4:30pm

Position Description Title/PD#: Credentialing Program Assistant/PD99876S