Credentialing Program Assistant

Credentialing Program AssistantIncumbent serves as the subject matter expert (SME) to LIPs and Service Chiefs on routine and complex matters related to C&P, including provider competence for the ongoing provider practice evaluation (OPPE) and focused provider practice evaluation (FPPE). Duties include, but are not limited to:Program Analysis and SupportAssists in developing short- and long-term goals necessary to accomplish the mission. Serves as SME in the field of credentials and clinical privileging.Assists in drafting local credentialing processes and Medical Staff Bylaws in compliance with all applicable regulations.

Receives and reviews VetPro reports to identify problem areas that require further investigation.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 and renewal of privileges which may affect the status of privileges granted for medical practice.Holds the credit card and is responsible for maintaining records, reconciling monthly charge statements and verifying legitimacy of requests for NPDB CQ enrollments/ renewals, licensure verification (if applicable), Educational Commission for Foreign Medical Graduates, American Medical Association, FSMB, National Student Clearing House, Work Number and, board certification (if applicable).ComplianceManages provider applications for LIPs C&P within the VAMC. Must have a broad knowledge of medical specialties and core privileges and is the technical advisor to clinical leadership and assures that complete documentation is available to support privileges granted to providers within their training and/or experience.Provides guidance and instruction to hospital staff in completing the required documentation for establishing privileges for LIPs.Quality AssuranceEnsures that application packages and other documents meet the technical requirements specific to the provider's specialty and verifies that the application folder and database account comply with these requirements.Communicates with LIPs to assure timely completion of applications and VetPro requirements.

Provides oversight of the application process, analyzes exceptions and deviations from the expected process, determines the course of action, and makes recommendations. Analyzes and manages issues related to documents that do not meet expected requirements, regulations, or guidelines, such as malpractice claims, adverse actions against licensures and/or certifications, FSMB reports, and National NPDB CQ reports.Coordinates incoming data from a variety of sources; establishes protocols for incoming data; organizes computerized data sets; and retrieves computerized data.Participates in the required annual C&P self-assessment and, if opportunities for improvement are identified, is involved in efforts to implement these improvements.Program AdvisorServes as technical advisor to the Executive Committee of the Medical Staff (ECMS) and the Credentials Committee.Refers to current issues, trends, problem areas, as well as recommended program revisions to Credentials and Privileging functions through the C&P Manager/Analyst.Prepares agendas for credential-related meetings. Responsibility to ensure LIPs credentials files are adequately prepared, maintained appropriately, and are accurate and current.

Conducts audits of provider time-limited credentials and ensures that detailed information is documented on provider exit review forms, privileging documents, FPPE and OPPE tracking system, credentialing program training requirements, telehealth providers monitoring system, and Committee recommended actions.Conducts final appointment into the VetPro database, after thoroughly researching, analyzing, and validating all data, information, documents, and signature authorities.Develops and provides routine and special reports as requested by the C&P Manager/Analyst.Work Schedule: Monday-Friday, 8am-4:30pmTelework: AD-HOC onlyVirtual: This is not a virtual positionPosition Description/PD#: Credentialing Program Assistant/ PD50453ARelocation/Recruitment Incentives: Not authorizedCritical Skills Incentive (CSI): Not approvedPermanent Change of Station (PCS): Not authorized