Credentialing Specialist

Job ID 88397 Location Sacramento Full/Part Time Full Time Job Summary Under the general supervision of the Medical Staff Governance and Credentialing Manager and the Director of Regulatory, Licensure & Accreditation and Medical Staff Governance & Credentialing, the Credentialing Specialist is an experienced professional responsible for independently managing complex credentialing and privileging activities for medical staff and advanced practice professionals at UC Davis Health. The position applies advanced knowledge of credentialing and privileging theory, regulatory requirements, medical staff policies, and applicable standards to evaluate the clinical qualifications of providers and ensure that practitioners are appropriately credentialed and privileged to provide patient care. The position has primary responsibility for managing the full range of credentialing and privileging activities, including the evaluation and processing of applications and supporting documentation and serving as the primary liaison for applications presented to the Credentials and Privileges Committee, Medical Staff Executive Committee, and Governing Body. The Credentialing Specialist works independently with minimal supervision and is expected to exercise considerable judgment, analytical ability, organization, and problem‑solving skills in addressing complex credentialing and privileging issues. The position serves as an experienced resource and organizational liaison among medical staff members, the Chief Medical Officer, Academic Personnel, clinical departments, and patient care areas. The position also provides technical expertise related to the Credential Stream credentialing database and represents UC Davis Health as an experienced credentialing and privileging professional during reviews and inquiries conducted by regulatory, accrediting, governmental, health plan, and University entities. Apply By Date September 6, 2026, at 11:59 PM Minimum Qualifications - For full consideration, applicants are encouraged to upload a license and/or certification if required for the position. Completion of applicable NCQA credentialing education/training or equivalent demonstrated experience and knowledge of NCQA credentialing standard's Several years of experience in medical credentialing or similar equivalent roles Experience applying NCQA credentialing standards and credentialing-integrity requirements in practitioner credentialing, primary-source verification, recredentialing, ongoing monitoring, documentation, and audit readiness Knowledge and understanding of Credentialing and Privileging principles and theories Skills to independently apply external regulatory guidelines dictated by California and Federal law and regulatory agency standards about credentialing in the healthcare industry (i.e., CMS, Title 22, The Joint Commission, NCQA and/or other accrediting bodies) and internal administrative policies Critical thinking, research, investigatory, and analytical skills to solve problems and propose solutions through the critical thinking process Knowledge and skills to assess and monitor credentialing theory, compliance, and effectiveness of credentialing and privileging processes Knowledge of medical terminology and medical and surgical procedures Skills to independently set and meet deadlines while multitasking, assigning precedence to competing priorities, to see multiple assignments through to completion on deadline and according to organizational goals. Skills to work collaboratively Skills to coordinate and integrate with others throughout the department, hospital, and campus Skills to communicate through all mediums and with all groups; often working under pressure of constantly changing deadlines and priorities Excellent verbal and written communication skills Thorough knowledge of data management and documentation methods used in medical credentialing Demonstrated computer and database knowledge, along with MS Office proficiency and ability to effectively use the credentialing database application Preferred Qualifications Certification as a CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional in Medical Services Management) Completion of NCQA credentialing education/training applicable to the organization's credentialing program Experience maintaining documentation and audit trails sufficient to support NCQA accreditation/certification and internal credentialing audits Knowledge of credentialing integrity and compliance practices, including maintaining accurate, complete, current, and confidential practitioner credentialing records Ability to identify credentialing discrepancies, gaps, and compliance issues and ensure timely resolution Key Responsibilities 70% - Credentialing and Privileging 30% - Computer Database Management and Analysis Department Overview Medical and Regulatory Affairs has overall responsibility for the management and oversight of the credentialing and privileging process at UC Davis Health. The department supports the quality and safety of patient care by ensuring that physicians, dentists, clinical fellows, nurse practitioners, psychologists, and other advanced practice professionals meet established qualifications and regulatory, organizational, and medical staff requirements for participation in patient care. Through formal, technical, and rigorous credentialing and privileging processes, Medical and Regulatory Affairs evaluates the education, training, experience, clinical qualifications, professional history, and other relevant information necessary to determine whether practitioners are qualified to provide specific patient care services. The department works collaboratively with medical staff leadership, clinical departments, Academic Personnel, hospital leadership, patient care areas, and other internal and external stakeholders to maintain compliance with applicable regulatory and accreditation requirements and to support the ongoing quality and safety of patient care. Department Specific Job Scope The Medical Staff Services Specialist 3 independently manages complex credentialing and privileging functions and serves as an experienced professional resource within Medical and Regulatory Affairs. The position is responsible for evaluating the clinical qualifications of providers and applying credentialing and privileging requirements to a diverse population of medical staff members and advanced practice professionals. POSITION INFORMATION Salary or Pay Range: $2,521.07 - $4,421.46 Salary Frequency: Bi-weekly Salary Grade: 20 UC Job Title: MED STF SVC SPEC 3 UC Job Code: 005519 Number of Positions: 3 Appointment Type: Career Percentage of Time: 100% Full-Time Shift (Work Schedule): Monday -Friday (8 AM to 4 PM) Location: North Addition Office Building, Sacramento, CA Union Representation: Non-Represented (PPSM) Benefits Eligible: Yes This position is hybrid (mix of on-site and remote work): Upon successful completion of the initial training period, the position is eligible to work remotely one (1) day per week. Benefits Outstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources, and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial, and career goals. Learn more about the benefits below and eligibility by visiting the UCnet Benefits Page or Benefits Summary for UC Davis Health Employees or Benefits Summary for UC Davis Employees. High-quality and low-cost medical plans to choose from to fit your family's needs UC pays for dental and vision coverage for you and your family Retirement plans for eligible employees, including Pension and other Retirement Saving Plans Supplemental insurance offered including additional life, short/long term disability, pet insurance, legal coverage, accident, critical illness and hospital indemnity Pregnancy and Parental Leave, Family & Medical Leave, Adoption Assistance and Pay for Family Care and Bonding for eligible employees Lactation Support Program and Family Care discounts and resources Employee Well-being resources and programming to support thriving in all aspects of employees' lives On-site Employee Assistance Program including access to free mental health services Generous amount of paid Holidays annually as outlined in the UC Policies or Collective Bargaining Agreements Paid Time Off/Vacation/Sick Time as outlined in the UC Policies or Collective Bargaining Agreements Continuing Education (CE) allowance and Staff Education Reimbursement Program for eligible employees Access to free professional development courses and learning opportunities for personal and professional growth Public Service Loan Forgiveness (PSLF) Qualified Employer and Student Loan Debt Counseling Program for eligible employees Physical Demands Standing - Occasional Up to 3 Hours Walking - Occasional, up to 3 Hours Sitting - Frequent, 3 to 6 Hours Lifting/Carrying 0-25 Lbs - Occasional, up to 3 Hours Pushing/Pulling 0-25 Lbs - Occasional, up to 3 Hours Bending/Stooping - Occasional, up to 3 Hours Squatting/Kneeling - Occasional, up to 3 Hours Twisting - Occasional, up to 3 Hours Reaching overhead - Occasional, up to 3 Hours Keyboard use/repetitive motion - Frequent, 3 to 6 Hours Mental Demands Sustained attention and concentration - Frequent, 3 to 6 Hours Complex problem solving/reasoning - Occasional, up to 3 Hours Ability to organize & prioritize - Frequent 3 to 6 Hours Communication skills - Frequent 3 to 6 Hours Numerical skills - Occasional Up to 3 Hours Constant Interaction - Frequent 3 to 6 Hours Customer/Patient Contact - Frequent 3 to 6 Hours Multiple Concurrent Tasks - Frequent 3 to 6 Hours Work Environment UC Davis is a smoke- and tobacco-free campus effective January 1, 2014. Smoking, the use of smokeless tobacco products, and the use of unregulated nicotine products (e-cigarettes) will be strictly prohibited on any UC Davis-owned or leased property, indoors and outdoors, including parking lots and residential space. Special Requirements - Please contact your recruiter with questions regarding which activities apply by position. This is a critical position, as defined by UC Policy and local procedures, and as such, employment is contingent upon clearing a criminal background check(s) and may include drug screening, medical evaluation clearance, and functional capacity assessment This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures, and training requirements Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer. A Culture of Opportunity and Belonging At UC Davis, we're committed to solving life's most urgent challenges and building a healthier, more resilient world. We believe in growing through every challenge, continually striving to improve, and welcoming new perspectives that strengthen our community. We recognize that a vibrant and innovative organization values both individual strengths and shared purpose. The best ideas often emerge when people with different experiences come together. As you consider joining UC Davis, we invite you to explore our Principles of Community, our Clinical Strategic Plan, and strategic vision for research and education. We believe you belong here. The University of California, Davis is an Equal Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or protected veteran status. To view the University of California's Anti-Discrimination Policy, please visit: Because we want you to feel seen and valued, our recruitment process at UC Davis supports openness and authenticity. Research shows that some individuals hesitate to apply unless they meet every qualification. You may be an excellent fit for this role-or the next one. We encourage you to apply even if your experience doesn't match every listed requirement. #YouBelongHere #LI-SM3 #CA-ZM To learn more about our background check program, please visit: #J-18808-Ljbffr