Credentials Specialist (Manhattan)

Credentials Specialist (Manhattan)

NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across 6 inpatient locations, its Perlmutter Cancer Center, and over 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise with over $1 billion in active awards from the National Institutes of Health.

Position Summary: We have an exciting opportunity to join our team as a Credentials Specialist (Manhattan). In this role, the successful candidate is responsible for initiating, processing, reviewing and analyzing physician/allied health applications for initial appointment in accordance with established credentialing standards.

Job Responsibilities:

• Performs other duties and assists with special projects as assigned.
• Initiates, processes, reviews and analyzes physician/allied health applications for initial appointment exercising discretion and independent judgment with respect to applicable credentialing standards.
• Conducts/reviews primary source verification and validation of credentialing documents including clinical education/training, board certification and eligibility, licensure, accreditation, work history, liability insurance and malpractice claims history. Assesses completeness of information and qualifications relative to credentialing standards.
• Independently identifies and flags adverse information from application materials for the purpose of conducting special follow-up investigations in preparation for Credentials Committee review. Uses discretion to escalate identified flags to management.
• Enters data from provider applications into Cactus database, including provider privileges, and uploads CAQH as applicable, focusing on accuracy and interpreting or adapting data to conform to defined data field uses.
• Independently prepares, issues, electronically tracks and follows-up on appropriate verifications for efficient processing of each individual application.
• Employs public relations skills and uses discretion in a wide variety of email, phone and in person contacts with internal and external sources for purposes of soliciting information and communicating information essential to the credentialing process and credentials investigations.
• Independently creates and generates data reports from the credentialing database to effectively manage and monitor the credentialing process and their applications.
• Internally audits, organizes and maintains provider files in accordance with established principles of legal documentation and confidentiality.
• Independently maintains tickler system for follow-up of unanswered correspondence. Investigates and resolves matters of significance on behalf of the department and escalates to management as appropriate.
• Organizes and prepares credential files for review by management, clinical department leadership and the Credentials Committee.
• Initiates, processes, reviews and analyzes requests for Additional Privileges, One Time Privileges and Changes of Status.
• Processes Temporary Privileges as applicable and approved
• Maintains a high degree of discretion and trustworthiness in the handling of confidential information associated with the credentialing process.
• Post Committee reviews and approvals, responsible for assuring file completeness and prompt, accurate and detailed communication regarding final on-boarding of new providers, including Post Committee approval letters, Delineation of Privileges (DOP) and communication to providers.

Minimum Qualifications: To qualify you must have a Bachelors' Degree and a minimum of three years experience in medical staff credentialing required or the equivalent combination of education and experience. Excellent verbal and written communication skills. Computer skills, including word processing and data base maintenance.

Preferred Qualifications: Medical staff credentialing certification from NAMSS (National Association of Medical Staff Services) preferred. Self-motivated with the ability to complete projects independently within established timeframes. Ability to handle multiple projects and deadlines. Ability to cope with interruptions, varying personalities, rush projects, and demanding medical staff. Must be well organized and able to prioritize responsibilities. Must have independent judgment and interpersonal relationship skills in working with medical staff leaders and other Departments in the NYU Health System.

Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

At NYU Langone Health, we are committed to supporting our workforce and their loved ones with a comprehensive benefits and wellness package. Our offerings provide a robust support system for any stage of life, whether it's developing your career, starting a family, or saving for retirement. The support employees receive goes beyond a standard benefit offering, where employees have access to financial security benefits, a generous time-off program and employee resources groups for peer support. Additionally, all employees have access to our holistic employee wellness program, which focuses on seven key areas of well-being: physical, mental, nutritional, sleep, social, financial, and preventive care. The benefits and wellness package is designed to allow you to focus on what truly matters. Join us and experience the extensive resources and services designed to enhance your overall quality of life for you and your family.

NYU Langone Health is an equal opportunity employer and committed to inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration. We require applications to be completed online.

View Know Your Rights: Workplace discrimination is illegal.

NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $66,299.99 - $81,375.00 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

To view the Pay Transparency Notice, please click here