Credentialing Program Assistant

U.S. Department of Veterans Affairs; Columbia Township (MO); On-site; USD 42,000 - 60,000; Full time

Job summary

The Credentialing Program Assistant supports the Chief of Staff at Harry S Truman VA Medical Center in Columbia, MO, providing administrative direction and technical support to credentialing and privileging operations.

Responsibilities include coordinating local credentialing processes, ensuring primary source verification, maintaining provider data (Licenses, DEA, NPDB, FSMB), and communicating regulatory changes to staff to ensure compliance with VHA and TJC standards.

Qualifications

• GS-06 level requires one year of specialized experience in credentialing and privileging.
• Experience drafting local credentialing processes and Medical Staff Bylaws.
• No educational substitution for the GS-06 level.

Responsibilities

• Assists C&P Manager in developing short- and long-term goals for the program.
• Identifies resources needed for the credentials program.
• Serves as SME in credentials field.
• Keeps leadership informed of regulatory changes and policies.
• Reviews VetPro reports to identify issues.
• Researches regulations to correct problems.
• Ensures provider data is accurate in VetPro.
• Verifies licensure, DEA, certifications, and other credentials.
• Coordinates with clinical departments on competency findings.
• Participates in annual C&P self-assessment and improvement efforts.
• Performs other duties as assigned.
• Work Schedule: Mon–Fri 8:00am–4:30pm.

Skills

Credentialing knowledge

Documentation & data tracking

Regulatory compliance

Guidance to staff

Tools

VetPro

NPDB

FSMB

Job description

Summary

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 direction and support to the credentialing and privileging (C&P) operations in Columbia - MO.

Summary

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 direction and support to the credentialing and privileging (C&P) operations in Columbia - MO.

Qualifications

To qualify for this position - applicants must meet all requirements by the closing date of this announcement. GS-06 grade level: One year of specialized experience (equivalent to the GS-05 grade level in the federal service); experience that equipped the applicant with the particular knowledge - skills and abilities (KSA's) and other characteristics to perform successfully the duties of the position - and that is typically in or related to the work of the position to be filled - in the normal line of progression for the occupation in the organization. Specialized experience includes: Assisting C&P Manager in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations. Provides guidance and instruction to hospital staff. Analyzes and manages issues. Collects - compiles - and tracks data. Prepares reports. Verifies required information to ensure acceptability of credentials and privileging in a medical setting There is no educational substitution for the GS-06 level. Experience refers to paid and unpaid experience - including volunteer work done through National Service programs (e.g. - Peace Corps - AmeriCorps) and other organizations (e.g. - professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies - knowledge - and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience - including volunteer experience.

Duties

• Duties include - but may not be limited to the following: C&P Duties (100%) The incumbent assists the 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
• Keeps leadership and appropriate administrative staff informed of program changes - new regulatory requirements - and policies and procedures pertaining to the C&P process
• 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 - adverse licensure or privileging actions - 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 broad knowledge of medical specialties
• Provides guidance and instruction to hospital staff in completing the required documentation of establishing credentialing for 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 with the credentials and privileging function of the credentials committee of the medical staff 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