Medical Staff Services Specialist

General Information

Job Name Medical Staff Services Specialist Department 8710020 - MEDICAL STAFF OFFICE SFMED Position type Full Time Workplace Fully On-Site Primary Location San Francisco, CA, United States Job ID 4925

Description & Requirements

Job Description

Applies credentialing policy knowledge to follow processes for maintaining department credentialing and licensure. Serves as day-to-day administrative support for the medical services office. Within a high-volume, goal-driven environment (estimated target: 15 credentialing files per week), analyzes, evaluates, processes, and self-audits applications pursuant to appropriate membership, privileges, and health plan enrollments for UCSF Medical Staff, Advanced Health Professionals, and CVO contracted facilities (LPPH&C, School of Dentistry, UBCP, Clinically Integrated Network (CIN) Partners, BCH Oakland, and others, as applicable). Implements policy and procedures, provides training and orientations to a variety of constituents, and supports efforts to sustain best practices. 

Qualifications Requirements: - Bachelor's degree or HS Diploma/GED and four years of relevant experience. - Knowledge of TJC, NCQA, CMS, DHS, DMHC, ACGME, and other applicable accreditation/regulatory requirements. - Competency in a paperless computer environment and understanding of provider data integrity standards (credentialing software, MS Office suite, Adobe Professional, document scanning/storage, web-based applications and tools, etc.). - Excellent ability to: interact with all levels of management; communicate effectively, both verbally and in writing; and function within a team and independently. - Ability to perform all commonly applicable functions in Microsoft Office Suite (Word, Excel, PowerPoint) and a medical credentialing database application. - Data analysis, research, and reporting skills. - Exceptional organizational skills and ability to set priorities as well as manage multiple demands effectively. - Role models and promotes best practices to maintain confidentiality and discretion to preserve. - HIPAA/Peer review protections as well as attorney-client privilege, as warranted. Knowledge of compliant revenue/billing practices to mitigate fraud/waste/abuse impacts on organization priorities/workplans. - Ability to work full-time in San Francisco when required. Preferences: - Three years working in a healthcare environment with emphasis on medical staff operations, academic medical centers, and/or provider credentialing for third-party payors and health plans. - Certified Professional Medical Services Management (CPMSM). - Certified Provider Credentialing Specialist (CPCS) within 18 months of hire from OMAG required to meet performance expectations of role. About UCSF The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences. We bring together the world’s leading experts in nearly every area of health. We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells. Pride Values UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence – also known as https://www.ucsf.edu/about/mission-and-values . In addition to , UCSF is committed to equity – both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available https://diversity.ucsf.edu/ . Join us to find a rewarding career contributing to improving healthcare worldwide. EEO 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 status under state or federal law.

Additional Details

Job Code MED STF SVC SPEC 2 (005525) Assignment Category Career IAP Level Tier C Plan (target potential payout of 3.5%, maximum of 5%) Job Family Clinical Support Services Campus 1 TBD Percentage (%) 100.00 Shift Length 8 hours Shift Type Day Bargaining Unit 99 Additional Shift Details M-F