What are the responsibilities and job description for the Manager of Credentialing and Privileging position at Alaska Native Tribal Health Consortium (ANTHC)?
The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction.
ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation’s largest state.
Our vision: Alaska Native people are the healthiest people in the world.
ANTHC offers a competitive and comprehensive Benefits Package for all Benefit Eligible Employees, which includes:
Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.
Summary
Responsible for coordinating all medical staff activities and acts as a liaison to medical staff, nursing and administration. Provides administrative support for medical staff functions and to the medical staff leadership including elected and appointed medical staff organization representatives to support them to fulfill their duties and obligations as defined by regulatory and licensing agencies, Medical Staff Bylaws, and accompanying documents.
Responsibilities
Supports the Medical Staff Office Director with all employee performance, coaching, and terminations. Must provide orientation and training to enable staff to perform the functions to which they are assigned. Establishes work standards and quality controls is a key expectation of this position.
M anages the credentialing or privileging process. Collaborates with physician leaders to develop and maintain a facility-specific, criteria-based clinical privileging system in accordance with regulatory requirements, accreditation standards, and organizational policies.
A pplies clearly defined credentialing or privileging processes to all practitioners/providers. Directs initial or reappointment/re-credentialing processes for eligible practitioners/providers.
M aintains credentialing database to ensure that accurate and current information is available to all stakeholders.
F osters good working rapport with members of the Medical Staff (i.e. Service Center Medical Directors, Medical Executive Committee), hospital executive/management team, other hospital personnel, representatives of regulatory agencies, Tribal Health Organizations (THOs), as well as other outside individuals (i.e. locums agencies, representatives from other facilities).
C oordinates telemedicine services, including contracts, credentialing, privileging, and provider notifications with providers and administrators at ANTHC and THOs.
M aintains working knowledge and compliance with departmental policies & procedures, Medical Staff Bylaws, Rules & Regulations, the Joint Commission (TJC), National Committee for Quality Assurance (NCQA), as well as regulatory and accrediting bodies as deemed necessary by administration.
P articipates in development and implementation of credentialing processes and procedures and advises supervisor of outstanding issues requiring leadership intervention.
C onducts and participates in, and maintains FPPE, OPPE and Peer Review documents.
A nalyzes and prepares practitioner/provider performance improvement and quality/competence data in clear, concise, and structured reports.
R ecognizes, investigates, and validates discrepancies and adverse information obtained. Coordinates an appropriate evaluation by physician leaders of gathered data.
C ommunicates findings and/or resulting actions to key stakeholders and the practitioner.
M anages departmental operations by conducting. Audits, assessments, procurement of data and/or information.
E ffectively implements, utilizes and maintains practitioner/provider credentialing processes and information systems (e.g., files, reports, minutes, databases) by analyzing the needs and resources of medical services/credentialing.
D evelops and implements tools and policies to support knowledge management, record-keeping, and internal and external communication.
R ecruits and supervises qualified staff to accomplish departmental operations and functions.
P erforms other duties as assigned.
Other Information
KNOWLEDGE and SKILLS
V alues and models integrity and honesty by acting in a just, fair and ethical manner and encouraging ethical behavior among others. Inspires trust and confidence among stakeholders through reliability, authenticity, and accountability.
E xpresses thoughts clearly, concisely, and effectively both verbally and in writing. Ensures a free flow of information and communication upward, downward and across the organization by actively listening and encouraging the open expression of ideas and opinions.
D isplays a credible presence and positive image. Develops other people’s confidence in self through consistent action, values and communication.
T akes all critical information into account, considering interrelationships among issues and implications for other stakeholders. Applies knowledge, expertise, sound judgment and other references and resources as necessary to generate and evaluate solutions and recommendations. Understands and appropriately applies principles, procedures, requirements, regulations, and policies.
O rganizes work, effectively prioritizes, and sets short- or long-term goals and strategies to achieve them.
A ligns communication, people, processes and resources to drive success.
E xhibits confidence and professional diplomacy while identifying, organizing, facilitating and /or sustaining mutually beneficial partnerships and alliances with people at all levels internally and externally.
F acilitates positive, professional, and constructive dialogue with the goal of motivating others to accept recommendations, cooperate, change behavior or find mutually acceptable solutions.
P resents in a confident, clear, and enthusiastic manner when addressing people in a large or small group.
D emonstrates a sound knowledge of the subject matter.
U nderstands concepts, key functions, terminology, and work products pertaining to legal, information technology, clinical competence evaluation, performance improvement, risk management, and human resources.
O rganizes information and data to identify/explain trends, problems, and their causes. Compares, contrasts, and combines information to determine underlying issues. Sees associations between seemingly independent problems or events to recognize trends, problems, and possible cause-effect relationships.
MINIMUM EDUCATION QUALIFICATION
A n Associate’s Degree in Business Administration or other related field. Progressively responsible professional work-related experience, education, or training may be substituted on a year-for-year basis for college education.
mInimum Experience Qualification
T wo (2) years professional work experience in health education, health related research, and/or health related program development, implementation and evaluation. An equivalent combination of relevant education and/or training may be substituted for experience.
AND
Supervisory - One (1) year involving employee supervision or Leadership experience.
MINIMUM CERTIFICATION QUALIFICATION
N /A
PREFERRED EDUCATION QUALIFICATION
N /A
Preferred Experience Qualification
E xperience in the Alaska Tribal Health System. Training or experience specific to worksite wellness programs is highly preferred, as is experience with implementation of systems change in worksite settings.
PREFERRED CERTIFICATION QUALIFICATION
N /A
a Dditional Requirements
N /A
ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation’s largest state.
Our vision: Alaska Native people are the healthiest people in the world.
ANTHC offers a competitive and comprehensive Benefits Package for all Benefit Eligible Employees, which includes:
- Medical Insurance provided through the Federal Employee Health Benefits Program as a Tribal Employee, with over 20 plans and tiers.
- Cost-Share Dental and Vision Insurances
- Discounted Pet Insurance
- Retirement Contributions with Pre-Tax or Roth options into a 403(b).
- 401(a) ANTHC Retirement Plan: After one year of employment, ANTHC will begin making matching contributions of up to 5% of your eligible pay, based on your own contributions. In addition, you may be eligible for an annual discretionary contribution of up to 3% from the employer.
- Paid Time Off starts immediately, earning up to 6 hours per pay period, with paid time off accruals increasing based on years of service.
- Eleven Paid Holidays
- Paid Parental Leave or miscarriage/stillbirth eligibility after six months of employment
- Basic Short/Long Term Disability premiums, Accidental Death and Dismemberment (AD&D) Insurance, and Basic Life Insurance are covered 100% by ANTHC, with additional options for Short-Term Disability Buy-Up Coverage and Voluntary Life for yourself and your family members.
- Flexible Spending Accounts for Healthcare and Dependent Care.
- Ancillary Cash Benefits for accident, hospital indemnity, and critical illness.
- On-Site Child Care Facility with expert-designed classrooms for early child development and preschool.
- Employee Assistance Program with support for grief, financial counseling, mental/emotional health, and discounted legal advice.
- Tuition Discounts for you and your eligible dependents at Alaska Pacific University.
- On-Site Training Courses and Professional Development Opportunities.
- License and certification reimbursements and occupational insurance for medical staff.
- Gym Access to Alaska Pacific University includes a salt water pool, rock climbing, workout gym, and steep discounts for outdoor equipment rentals.
- Emergency Travel Assistance
- Education Assistance or Education leave eligibility
- Discount program for travel, gym memberships, amusement parks, and more.
Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.
Summary
Responsible for coordinating all medical staff activities and acts as a liaison to medical staff, nursing and administration. Provides administrative support for medical staff functions and to the medical staff leadership including elected and appointed medical staff organization representatives to support them to fulfill their duties and obligations as defined by regulatory and licensing agencies, Medical Staff Bylaws, and accompanying documents.
Responsibilities
Supports the Medical Staff Office Director with all employee performance, coaching, and terminations. Must provide orientation and training to enable staff to perform the functions to which they are assigned. Establishes work standards and quality controls is a key expectation of this position.
M anages the credentialing or privileging process. Collaborates with physician leaders to develop and maintain a facility-specific, criteria-based clinical privileging system in accordance with regulatory requirements, accreditation standards, and organizational policies.
A pplies clearly defined credentialing or privileging processes to all practitioners/providers. Directs initial or reappointment/re-credentialing processes for eligible practitioners/providers.
M aintains credentialing database to ensure that accurate and current information is available to all stakeholders.
F osters good working rapport with members of the Medical Staff (i.e. Service Center Medical Directors, Medical Executive Committee), hospital executive/management team, other hospital personnel, representatives of regulatory agencies, Tribal Health Organizations (THOs), as well as other outside individuals (i.e. locums agencies, representatives from other facilities).
C oordinates telemedicine services, including contracts, credentialing, privileging, and provider notifications with providers and administrators at ANTHC and THOs.
M aintains working knowledge and compliance with departmental policies & procedures, Medical Staff Bylaws, Rules & Regulations, the Joint Commission (TJC), National Committee for Quality Assurance (NCQA), as well as regulatory and accrediting bodies as deemed necessary by administration.
P articipates in development and implementation of credentialing processes and procedures and advises supervisor of outstanding issues requiring leadership intervention.
C onducts and participates in, and maintains FPPE, OPPE and Peer Review documents.
A nalyzes and prepares practitioner/provider performance improvement and quality/competence data in clear, concise, and structured reports.
R ecognizes, investigates, and validates discrepancies and adverse information obtained. Coordinates an appropriate evaluation by physician leaders of gathered data.
C ommunicates findings and/or resulting actions to key stakeholders and the practitioner.
M anages departmental operations by conducting. Audits, assessments, procurement of data and/or information.
E ffectively implements, utilizes and maintains practitioner/provider credentialing processes and information systems (e.g., files, reports, minutes, databases) by analyzing the needs and resources of medical services/credentialing.
D evelops and implements tools and policies to support knowledge management, record-keeping, and internal and external communication.
R ecruits and supervises qualified staff to accomplish departmental operations and functions.
P erforms other duties as assigned.
Other Information
KNOWLEDGE and SKILLS
V alues and models integrity and honesty by acting in a just, fair and ethical manner and encouraging ethical behavior among others. Inspires trust and confidence among stakeholders through reliability, authenticity, and accountability.
E xpresses thoughts clearly, concisely, and effectively both verbally and in writing. Ensures a free flow of information and communication upward, downward and across the organization by actively listening and encouraging the open expression of ideas and opinions.
D isplays a credible presence and positive image. Develops other people’s confidence in self through consistent action, values and communication.
T akes all critical information into account, considering interrelationships among issues and implications for other stakeholders. Applies knowledge, expertise, sound judgment and other references and resources as necessary to generate and evaluate solutions and recommendations. Understands and appropriately applies principles, procedures, requirements, regulations, and policies.
O rganizes work, effectively prioritizes, and sets short- or long-term goals and strategies to achieve them.
A ligns communication, people, processes and resources to drive success.
E xhibits confidence and professional diplomacy while identifying, organizing, facilitating and /or sustaining mutually beneficial partnerships and alliances with people at all levels internally and externally.
F acilitates positive, professional, and constructive dialogue with the goal of motivating others to accept recommendations, cooperate, change behavior or find mutually acceptable solutions.
P resents in a confident, clear, and enthusiastic manner when addressing people in a large or small group.
D emonstrates a sound knowledge of the subject matter.
U nderstands concepts, key functions, terminology, and work products pertaining to legal, information technology, clinical competence evaluation, performance improvement, risk management, and human resources.
O rganizes information and data to identify/explain trends, problems, and their causes. Compares, contrasts, and combines information to determine underlying issues. Sees associations between seemingly independent problems or events to recognize trends, problems, and possible cause-effect relationships.
MINIMUM EDUCATION QUALIFICATION
A n Associate’s Degree in Business Administration or other related field. Progressively responsible professional work-related experience, education, or training may be substituted on a year-for-year basis for college education.
mInimum Experience Qualification
T wo (2) years professional work experience in health education, health related research, and/or health related program development, implementation and evaluation. An equivalent combination of relevant education and/or training may be substituted for experience.
AND
Supervisory - One (1) year involving employee supervision or Leadership experience.
MINIMUM CERTIFICATION QUALIFICATION
N /A
PREFERRED EDUCATION QUALIFICATION
N /A
Preferred Experience Qualification
E xperience in the Alaska Tribal Health System. Training or experience specific to worksite wellness programs is highly preferred, as is experience with implementation of systems change in worksite settings.
PREFERRED CERTIFICATION QUALIFICATION
N /A
a Dditional Requirements
N /A