Senior Credentialing Specialist - Medical Staff Admin - FT Days

UCI Health; Irvine (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

UCI Health seeks an advanced credentialing professional to manage credentialing and privileging workflows for medical staff governance. You will coordinate applications, ensure policy compliance, and mentor junior specialists.

The role requires a high level of accuracy, excellent communication with medical staff, and ability to work under pressure in a busy health system environment.

Qualifications

• Five years in credentialing, privileging, and policy administration.
• Knowledge of FPPE/proctoring processes and procedures.
• Advanced knowledge of Joint Commission, CMS Conditions of Participation, NCQA, and Title 22 standards.

Responsibilities

• Coordinate credentialing and privileging applications and follow up.
• Serve as a link between department senior management and medical staff governance.
• Mentor other credentialing specialists and support department operations.

Skills

MS Office Suite proficiency

Data analysis

Verbal and written English

Discretion and judgment

Policy and process administration

Project management

Time management

Communication with medical staff

Education

Bachelor's degree or equivalent

NAMSS CPCS/CPMSM certification

Tools

MS Office Suite (Outlook, Word, Excel, PowerPoint, SharePoint)

Job description

Who We Are

UCI Health is one of California’s largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health — Orange, UCI Health — Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties.

Who We Are

UCI Health is one of California’s largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health — Orange, UCI Health — Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties. As Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Your Role on the Team

Position Summary

Incumbent is an advanced technical professional who functions with minimal supervision applying extensive knowledge and expertise in the field to problem solve, formulate strategies in unique and complex situations, and administer policies, processes, and resources. The Senior Credentialing Specialist serves as an essential link and resource between department senior management and the medical staff to coordinate the operational processes and ongoing credentialing, privileging, and medical staff governance functions of the Medical Staff Administration Department. Responsible for review, analysis and follow up, and processing credentialing and privileging applications and ensuring compliance with organizational policies and accrediting and regulatory standards. Responsible for meeting management to the Credentials Committee. Acts as mentor to other credentialing specialists, and provides other support and assistance within the department as needed or assigned.

Required Qualifications

What It Takes to be Successful

• Must possess the skill, knowledge and abilities essential to the successful performance of assigned duties
• Must demonstrate customer service skills appropriate to the job
• Minimum of five (5) years in the overall field with expertise in specific areas, including credentialing, privileging, formulating strategies, and administering policies and processes
• Knowledge of FPPE/proctoring processes and procedures
• Excellent verbal and written English communication skills
• Discretion and judgment in the handling of confidential and/or sensitive information
• Demonstrated skill and ability to independently set and meet deadlines, multi-task, and effectively manage competing priorities
• Demonstrated advanced skill and proficiency in MS Office Suite (Outlook, Word, Excel, PowerPoint, SharePoint)
• Demonstrated advanced knowledge in data analysis, research and reporting, particularly with respect to licensure compliance
• Demonstrated ability to multi-task and manage time and prioritize projects efficiently and effectively
• Demonstrated ability to apply sound judgment and formulate strategies in ambiguous situations and effectively manage change
• Demonstrated ability to apply knowledge and recommend viable solutions for complex situations
• Current NAMSS certification as CPCS and/or CPMSM
• Bachelor's degree in related area and / or equivalent experience / training
• Advanced knowledge of Joint Commission, CMS Conditions of Participations, and NCQA and Title 22 accreditation standards and regulations
• Advanced knowledge and expertise in medical staff credentialing and privileging processes and procedures
• Advanced analytical, critical thinking, organizational, and project management skills
• Ability to maintain professional demeanor and poise while working under pressure, meeting deadlines, and managing changing priorities
• Ability to maintain a work pace appropriate to the workload
• Ability to complete job responsibilities with a high degree of accuracy under minimum supervision

Preferred Qualifications

• Minimum of two (2) years meeting management experience
• Knowledge of university and medical center organizations, policies, procedures, and forms
• Experience with MD-Staff Credentialing Database Software
• Dual NAMSS certification as CPMSM and CPCS

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions Of Employment

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

Exercise the utmost discretion in managing sensitive information learned in the course of performing their duties. Sensitive information includes but is not limited to employee and student records, health and patient records, financial data, strategic plans, proprietary information, and any other sensitive or non-public information learned during the course and scope of employment. Understands that sensitive information should be shared on a limited basis and actively takes steps to limit access to sensitive information to individuals who have legitimate business need to know. Ensure that sensitive information is properly safeguarded. Follow all organizational policies and laws on data protection and privacy. This includes secure handling of physical and digital records and proper usage of IT systems to prevent data leaks. The unauthorized or improper disclosure of confidential work-related information obtained from any source on any work-related matter is a violation of these expectations.

• Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy.

We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at [e-mail] or at [phone], Monday - Friday from 8:30 a.m. - 5:00 p.m.

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization