As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. **Job Location (Full Address):** 120 Corporate Woods, Rochester, New York, United States of America, 14623 **Opening:** Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910397 URMC Medical Staff Services Work Shift: UR - Day (United States of America) Range: UR URG 109 H Compensation Range: $26.90 - $37.66 _The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE: Coordinates departmental activities, including credentialing approval process to ensure quality in conducting, maintaining, and communicating the medical and allied health professional staff credentialing, privileging, and primary source verification process. Serves as a resource of the department, trains team, and collaborates with management to advance the quality of practitioners and patient safety of the facility. **ESSENTIAL FUNCTIONS** + Electronically routes the credentials files to the department chief/chair or designee for review and recommendation for membership and privileges for Strong Memorial Hospital and Highland Hospital. Coordinates the weekly expedited credentials committee and board approval process for credentials files being recommended by the departments for Strong Memorial Hospital and Highland Hospital. Coordinates emergency privilege requests for hospital privileges as needed for all UR affiliates. May complete final review of files before submission. + Prepares practitioners credentials files for presentation to affiliate and non-affiliate CVO clients and coordinates the electronic routing through the credentialing software or other secure electronic process. Coordinates the proxy credentialing process associated with telehealth activities and assists management with tracking. Assists management with review and assessment of departmental functions and services to identify areas in need of review or improvement and implement changes as needed. Engages in ongoing collaboration and coordination of activities with the Credentialing Managers and other Coordinators. Represents the Medical Staff Office and CVO for regulatory audit/surveys by the JC, NCQA, DOH, CMS or any other regulatory agency as needed. Responds to inquiries from other healthcare organizations and interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise. Serves as a resource for staff pertaining to medical staff bylaw, policies, and procedures. Represents the Medical Staff Services Department for various initiatives and/or committee meetings as needed. Serves as the primary back up to all credentialing staff. Serves as a Team Peer Interviewer as needed. + Coordinates the Enrollment of Liability insurance for qualified practitioners and follows up on issues related to coverage as they arise. Monitors and processes the National Practitioner Data Bank Continuous Query Renewals. Responds to inquiries from internal departments and practitioners related to practitioner profiles/data associated with software data feeds to electronic health record and Web Services applications. Maintains and updates various data fields and dictionary in the credentialing software database related to hospital and practice addresses and practitioner information as needed. + Analyzes application and supporting documents for accuracy and completeness and informs the practitioner of the application status, including the need for any additional information or corrections. Obtains, researches, and evaluates information from primary sources to ensure compliance with accreditation and regulatory standards in order to validate the accuracy of applications for one or more decision making bodies, including a thorough background investigation and primary source verification of all components of the application file, such as applicants education and training, licensure, work history, hospital affiliation history, malpractice claims history, board certification status, criminal background, evaluation of health status, and peer recommendations. Recognizes, investigates, and validates discrepancies and adverse information obtained during the application process to ensure that review and approval bodies have information needed to make informed credentialing decisions. Communicates the status of the applicant files directly to providers and various department representatives, clients, and/or affiliates and coordinates efforts to obtain necessary information and/or documentation to assure deadlines are met. Communicates the status of expiring credentials, such as license, DEA, health reviews, PPD, infection control, specialty privilege requirements, etc., directly to providers and various department representatives and/or outside organizations, clients or affiliates and coordinates efforts to obtain necessary information and/or documentation to ensure deadlines are met. Assists with various aspects of the credentialing expirables process, including but not limited to, the ongoing monitoring of sanctions, board certification status, and current malpractice coverage. + Audits and monitors the credentialing application/files processed by Credentialing staff to ensure appointments are processed in the required timeframes and meet regulatory requirements, including all required primary source verifications and other documentation. Coordinates and monitors the review and analysis of practitioner applications and accompanying documents to ensure files meet regulatory requirements. Documents and tracks performance statistics of the Credentialing team’s application processing related to accuracy and communicates with the managers when issues are identified. Reviews statistics regarding performance measures and goals with management regularly and assists with identifying trends. Trains new and existing staff on how to process initial and/or reappointment/re-credentialing applications. Processes requests for privileges when applicable, ensuring compliance with criteria outlined in clinical privilege descriptions. Other duties as assigned. **MINIMUM EDUCATION & EXPERIENCE** + Associate's degree in business or healthcare related field and 3 years of experience in Medical Staff credentialing and/or payer enrollment functions required + Or equivalent combination of education and experience **KNOWLEDGE, SKILLS AND ABILITIES** + Fluent English language skills (oral and written) required + Proficiency in MS Office (e.g. Word, Excel, and PowerPoint), email, and internet required + Knowledge of and experience with Joint Commission, CMS, and NCQA Regulations related to medical staff services and Commercial Payers Credentialing preferred + Exceptional interpersonal and communication skills preferred + Ability to develop and maintain relationships with a variety of key stakeholders across the organization preferred + Knowledge of and experience with database applications preferred **LICENSES AND CERTIFICATIONS** + Certified Medical Professional Services Management (CPMSM) upon hire preferred + Certified Provider Credentialing Specialist (CPCS) upon hire preferred **EOE Minorities / Females / Protected Veterans / Disabled:** The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations. Notice: If you are a **Current** **Employee,** please **log into myURHR** to search for and apply to jobs using the Jobs Hub. Your application, if submitted using this portal, cannot be moved forward. **Learn. Discover. Heal. Create.** Located in western New York, Rochester is our namesake and our home. One of the world’s leading research universities, Rochester has a long tradition of breaking boundaries—always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better. If you’re looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals At the University of Rochester, we commit to diversity, equity, and inclusion and united by a strong commitment to be ever better—Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.