Details
Posted: 08-Mar-24
Location: San Francisco, California
Type: Full-time
Salary: Open
Categories:
Staff/Administrative
Internal Number: 77037BR
Works on strategic relationships and joint ventures at all levels of complexity. Within the strategic framework of UCSF Health expansion, the Network Credentials Specialist initiates and cultivates partnerships with department management, medical staff, and hospital/health plan leadership to ensure compliance and optimal efficiency for appropriate membership, privileges, and health plan enrollments on behalf of UCSF Medical Staff, Advanced Health Professionals, and CVO contracted facilities.
This person is the first responder to onboarding and revenue channel disruptions as well as auditing functions according to facility Bylaws, Rules, and Regulations; Credentialing Policy and Procedures; and other applicable accreditation/payor standards (e.g. NCQA, TJC, DHS, DMHC, CMS, delegated credentialing agreements, etc.). Moreover, this person will facilitate and support committees and continuous performance improvement efforts to achieve department and organization goals/deadlines/work plans. This person will assist in implementing policy and procedures, provide training and orientations to a variety of constituents and support efforts to sustain best practices.
This position works directly with the Network Team, Strategy and the Director of Affiliate Network Credentialing to develop and establish sustainable workflow processes related to credentialing/payor enrollment of community providers who fall under UCSF Health strategic growth.
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