Provider Credentialing Consultant

About the role

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. This position is for use in Health Plans Departments only and is responsible for all aspects of the credentialing process including, but not limited to, ensuring healthcare professionals meet all regulatory requirements, maintaining current information for each provider via the provider database or credentialing system and coordinating with the systems team for Epic updates. This position must maintain and manage a credentialing workflow to ensure accurate and timely credentialing of new providers and re-credentialing of existing providers. Corporate Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

Responsibilities

• Facilitates monthly credentialing and three year re-credentialing process for medical and allied health professional staff to ensure compliance with the bylaws and regulatory requirements.
• Implements process improvements as necessary to increase efficiency while ensuring compliance with bylaws and regulatory requirements.
• Participates in annual audits of the credentialing program.
• Maintains all credentialing documentation and provider updates to ensure reliable, efficient retrieval of information by staff.
• Analyzes data between provider database and Epic and reports discrepancies.
• Maintains data integrity in provider database regarding credentialing information.
• Assists with completion of special projects as requested by various internal departments or in support of requests from regulatory agencies, contracting agencies or other internal/external organizations.
• Exhibits excellent customer relations with office visitors, department coordinators, committee members, coworkers and outside contacts through events such as provider education fairs and seminars.

Skills

• Knowledge of appropriate credentialing requirements as well as of government regulations related to the establishment and maintenance of credentialing procedures.
• Ability