Program Support Assistant - Credentialing Program Assistant

Job Title

Program Support Assistant - Credentialing Program Assistant

Duties

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Major Duties:

• Responsible for collecting relevant data and the decision-making process to ensure that qualified health care professionals are providing appropriate care in appropriate settings.
• Responsible for the audit of all required credentials for authenticity and veracity in accordance with TJC standards and VHA policies and procedures.
• Incumbent will become familiar with privileging processes and may be proctored for the position of SME for credentialing and privileging.
• Incumbent is responsible for all credentialing requirements as outlined in policy.
• Incumbent is responsible for internal monitoring for compliance and timely update of expiration of time-limited credentials including, but not limited to, monitoring of licensure, registration, or certification expirations and continuous enrollment in the NPDB continuous query program for licensed providers.
• Assists C&P Manager or Analyst in drafting local credentialing procedures for LIP and Non-LIPs.
• Receives and reviews correspondence and communications for the credentials function and determines which items require immediate attention and which are confidential in nature.
• Receives and reviews VetPro reports detecting problem areas requiring further investigation.
• Manages provider applications (initial) for Non-LIPs credentialing within the VAMC.
• Incumbent must have knowledge of medical specialties.
• Assures application packages and other documents meet technical requirements per specialty of provider and assures application folder and database account (VetPro or other internal databases and spreadsheets) meet technical requirements.
• Communicates with Non-LIPs to assure timely completion of applications and VetPro requirements.
• Provides oversight to application process
• Analyzes exceptions and deviations in expected application process
• Determines course of action and makes recommendations.
• Determines processes for coordination of incoming data and documents from a variety of sources.
• Reviews documents and applications for omissions and inconsistencies and assures data entry is complete and accurate to meet VHA policy and regulation, and TJC standards.
• Reviews documents received and determines course of action based on information provided within documents.
• Contacts provider for omissions and/or inconsistencies in information; initiates primary source verification of credentials.
• Analyzes and manages issues related to documents that do not meet expected requirements, regulations or guidelines such as adverse actions against licensures, certifications, and NPDB) CQ reports.
• Independently selects appropriate method of validation, based on approved sources.
• Manages the work involving the tracking of data and documents in support of the credentialing operation.
• Refers current issues, trends, problem areas as well as recommended program revisions to Credentials functions through the C&P.

Work Schedule: Monday - Friday, 8:00am-4:30pm

Telework: This position is Adhoc eligible

Virtual: This is not a virtual position.

Position Description/PD#: PD00957A

Relocation/Recruitment Incentives: Not Authorized

Permanent Change of Station (PCS): Not Authorized