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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in credentialing processes, data management, and regulatory compliance within healthcare settings. Proficient in analytical thinking, communication, and maintaining data integrity while adhering to accreditation standards.
Highest-signal resume keywords
Credentialing Process OversightData Management and IntegrityRegulatory Compliance KnowledgeNAMSS CPCS and/or CPMSM CertificationAnalytical and Critical Thinking Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data EntryDatabase UtilizationMedical TerminologyProcess AuditsOperational AuditsData AnalysisCredentialing Database ManagementSystematic AuditsElectronic Work ProcessesMulti-tasking
Soft Skills
Strong Analytical SkillsExcellent Communication SkillsAttentive Listening SkillsOrganizational SkillsConfidence in Interactions
Tools & Technologies
Microsoft ApplicationsAdobe Acrobat ProfessionalCredentialing DatabasesWeb-based ApplicationsData Standards
Certifications & Qualifications
NAMSS CPCS CertificationNAMSS CPMSM Certification
Industry Keywords
Joint CommissionCMSNCQAProtected Health Information (PHI)Healthcare Credentialing
About the role
Key responsibilities & impact- Oversee the initial credentialing process
- Analyze and evaluate primary source verification data and documents
- Perform data entry and maintain data integrity in the credentialing database
- Analyze and process initial applications using independent critical thinking and investigative review
- Maintain knowledge of and adhere to hospital and external accreditation and regulatory standards, including Joint Commission, CMS, and NCQA
- Serve as a content expert and participate in onboarding and training new team members
- Apply current trends and practices in credentialing
- Assist with initial credentialing projects
- Manage data quality and integrity for web-based applications through systematic audits
- Analyze and manage credentialing database data according to strict data standards
- Manage pending staff database records
- Support integration of new hospital acquisitions by setting up staff records in MSOW, organizing scanned files, and training new team members
- Assist the CVO System Manager with creating electronic work processes in the credentialing database
- Participate in development of new technologies and database modules and perform upgrade testing
- Audit initial appointment files for newly credentialed providers and status/privilege changes
- Ensure requirements are met and set up practitioner records that feed multiple downstream systems
- Perform other duties as assigned and comply with organizational policies and standards
- Maintain the security and appropriate use of patient PHI
Requirements
What you’ll need- Bachelor's Degree required, or three years of direct credentialing experience accepted in lieu of a bachelor's degree
- 3+ years of experience working in a similar role, preferably in a healthcare setting
- 2+ years of experience with database utilization and data management
- Strong analytical and quantitative skills
- Advanced verbal, writing, and editorial skills
- Attentive listening skills
- Confidence interacting with UH Senior Leaders, Physicians, Board Members, and outside agencies
- Critical thinking skills for independent procedural decisions and judgments
- Skill in establishing priorities and independently coordinating day-to-day activities
- Knowledge of medical terminology
- Excellent communication and organizational skills
- Ability to work in a fast-paced environment
- Ability to multi-task
- Excellent computer skills, including Microsoft applications, Adobe Acrobat Professional, and credentialing databases
- Experience performing process, operational, and system audits
- Analytical thinking, organization, and attention to detail
- NAMSS CPCS and/or CPMSM certification required within 5 years
- Ability to safely and securely maintain Protected Health Information (PHI)
- Ability to meet occasional travel requirements
Benefits
Comp & perks- Remote work
- Full-time regular employee status
- Day shift
- Annual training
- NAMSS CPCS and/or CPMSM certification support/requirement within 5 years