How to Apply
A cover letter is required for consideration for this position and should be attached as the first page of your resume or CV. The cover letter should address your specific interest in the position and outline skills and experience that directly relate to this position. Resumes or CVs submitted without a cover letter will not be considered.
Provides a full range of professional services for credentialing, recredentialing, processing applications and verifying licensing and certifications, monitoring sanctions, assessing competency, and processing privileging, as appropriate, for Specified Personnel Professionals (SPPs are Advanced Practice Registered Nurses and Physician Assistants), by applying expert knowledge, expertise, and experience. Acting as a specialist in the complex Michigan Medicine credentialing process, has the authority to make independent decisions on matters of significance within the scope of responsibilities through analyzing, comparing, and evaluating various courses of action.
- Accountability for completion of initial appointment/reappointment, credentialing, and privileging following strict requirements of Centers for Medicare and Medicaid (CMS), The Joint Commission (TJC), the National Committee for Quality Assurance (NCQA), Healthcare Facilities Accreditation Program (HFAP), and Utilization Review and Accreditation Commission/American Accreditation Health Care Commission (URAC) to ensure the safety of our patients and safeguard Michigan Medicine against loss of accreditation, malpractice claims, and claims of negligent credentialing.
- Identifies red flags during the credentialing and privileging process, with authority to halt the process until the issue has been resolved, and is empowered, using strong analytical skills and judgment, to resolve locally or determine if the issue should be escalated. The credentialing specialist autonomously conducts the final analysis meticulously before deeming the credentialing packet as complete and ready for committee review and Board approval.
- Conducts all primary source verification necessary to complete the credentialing and privileging process maintaining standards in accordance with policies, procedures, rules, regulations, and accreditation requirements. Through delegated credentialing contracts, the credentialing specialist completes this work on behalf of each contracted plan, leveraging the contracts to expedite enrollment and reimbursement.
- Using expert knowledge, creativity, and ingenuity, identifies and implements ideas for process improvement using LEAN tools and strategies, wherever possible, keeping within the confines of the rules, regulations, and accreditation requirements to develop a more efficient process while still providing a safeguard to the institution.
- Applies broad knowledge and ability in interpretation and dissemination of policies, procedures, and process/rules/regulations/law changes, with regard to credentialing and recredentialing for practitioners at Michigan Medicine. Will act in an advisory capacity when questions or concerns on policies and procedures are raised.
- Ensure regulatory and accreditation agencies readiness with 14 health plans, triennial and biennial Joint Commission surveys for both routine and three specialty certifications, ad hoc CMS, and State of Michigan surveys, by analyzing credentialing records to affirm all requirements are met.
- Maintains the confidentiality of credential information, exercising due caution and discretion in responding to inquiries for information.
- Maintains and protects the integrity of the credentialing database as the source of truth for privileged provider information throughout the health system’s various IT systems such as the electronic health record, online provider directory, and billing system. Ensures database accuracy so that Provider Enrollment can complete health plan enrollment.
- Management and maintenance of expirables such as license, certification, and other credentials to maintain compliance with State law, policies, and procedures.
- Clearly and accurately presents complicated and exacting information with regard to credentialing, recredentialing, and privileging to the clinical departments, providers, and institutional stakeholders.
- Responds to inquiries and complaints regarding matters of a sensitive or confidential nature, exercising initiative, independent judgment, and diplomacy, with an excellent customer service oriented attitude.
- Represent Michigan Medicine and MSS in local, state, and national Medical Staff Services organizations (MAMSS, NAMSS).
- Bachelor’s degree or equivalent combination of education and experience.
- 1-2 years of credentialing and privileging experience.
- Knowledge of accreditation and regulatory requirements for credentialing and privileging.
- LEAN training or complete LEAN training within 3 months of hire.
- Demonstrated excellent interpersonal, problem-solving and communication skills, both written and oral.
- Ability to make independent decision on matters of significance using analytical skills and sound judgment
- Excellent organizational and multi-tasking skills.
- Ability to work effectively, cooperatively and professionally with a diverse group of faculty and staff, and aid in the training and education of all existing and new staff.
- Accurate and detail oriented, along with the ability to handle multiple tasks and priorities simultaneously with numerous interruptions.
- Must be able work under pressure in a fast-pasted environment, with strong time management skills.
- Demonstrated ability to work independently with a positive attitude.
- 3-5 years of credentialing and privileging experience.
- Experience with CACTUS by symplr® credentialing software.
- CPCS certification or willingness to become certified within 3 years of employment.
- Extensive knowledge of credentialing and privileging, as well as the Michigan Medicine hiring process.
- Knowledge of Hospital or clinical department policies and procedures.
This position is located at 2500 Green Road, Suite 700 in Ann Arbor.
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.