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Medical Credentialing Administrator
2 months ago
Note: Legitimate correspondence for these positions will only come from @jyginnovations.com or from isolved
Medical Credentialing Administrator
About JYG Innovations
JYG Innovations (JYG) is a professional solutions and services company focused on providing innovative and exceptional service in the Defense, State/Local and Commercial sectors. With a primary focus on IT Solutions, Cyber Security, Research and Analysis, and Medical/Clinical Staffing, JYG continues to receive exceptional customer satisfaction surveys due to the outstanding technical expertise and performance of its employees and strategic partners.
Location: St. Louis, MO
Employment: Full Time
Targeted Start Date: September 2024
Benefits: JYG offers exceptional benefits, including Medical/Dental/Vision, short and long-term disability, life insurance, paid vacation, paid holidays, 401(k) and semi-monthly direct deposit.
What You Will Be Doing:
In this role you will oversee the day-to-day Credentialing and Privileging (C&P) program operations encompassing aspects of inpatient, emergency and/or ambulatory care and support functions within the Saint Louis Medical Military-Civilian Partnership (STL-MCP) through USAFSAM/711th HPW via the Office of Military Medicine (OMM), which oversees clinical rotations by military medical personnel from multiple units at non-military hospitals in Eastern Missouri and Southern Illinois. You will be responsible to support multiple medical units, two civilian universities (Saint Louis University & Washington University in Saint Louis) and their civilian medical facilities & affiliates [SSM Health Saint Louis University Hospital (SLUH) & Barnes Jewish Hospital (BJH)] and the Mercy Hospital System hereby referred to as Civilian Healthcare Organizations (CHCOs). Additionally you will enable timely, high quality health care which is essential to sustaining clinical currency and medical readiness skills for permanent and rotating privileged providers.
Requirements:
- Bachelor's degree in business, management, or a health-related field, and at least 2 years of Knowledge of federal and civilian accrediting agency standards, state/national requirements and other regulatory agency requirements regarding licensing and certification, and legislation and laws pertaining to health care delivery systems experience in the field or in a related area(s)
- Knowledge and understanding of applicable Air Force and professional standards is mandatory. Knowledge of military and civilian guidelines that govern policy and procedure, successful completion of USAFSAM's and Department's orientation programs is required
- Knowledge of credentialing and privileging functions, theories, and techniques, executive orders, regulations, policies, and concepts that pertains to credentialing and privileging management. Knowledge of and skill in applying analytical and evaluative methods and techniques to issues or studies concerning the efficiency and effectiveness of Credentialing and Privileging Program operations
- Knowledge applicable to a wide range of health care administration and management functions to include pertinent laws, regulations, policies and precedents which affect the use of program and related support resources
- Extensive knowledge of Inspection standards and guidelines, Title IV of Public Law 99-660, DoD regulations and directives, Accreditation Standards (i.e., TJC), and state laws pertaining to medical staff issues and their impact on the facility's credentialing and privileging policies, procedures, and programs in order to evaluate compliance with Air Force, governmental, and private health inspection agency policies and guidelines, advise the military commanders, OMM Board of Directors, military and/or civilian Chiefs of Staff, and/or civilian organizations' Chief Executive Officers on program deficiencies and provide recommendations for implementation of corrective actions
- Knowledge of procedures of the National Practitioner Data Bank (NPDB), Federation of State Medical Boards (FSMB), Drug Enforcement Administration (DEA) as relates to the issuance and maintenance of health care provider DEA licensure, Provider Enrollment, Chain and Ownership System (PECOS), the Health Insurance Portability and Accountability Act (HIPAA) as it relates to Protected Health Information (PHI) and state and local regulatory agencies in order to safeguard patient safety and confidentiality during provision of care by all healthcare providers rotating through the CHCOs and maintain verification and continuity of licensure, certification, and adverse reporting for clinicians
- Non-Disclosure Agreement (NDA) in place
- US Citizenship is required for this position
Preferred Qualifications:
- Certification in Certified Professional Credentials Specialist and/or Certified Professional Medical Services Management is desired
- Master's degree in business, management, or a health-related field, and at least 2 years of experience in the field or in a related area(s)
Must be able to provide proof of US Citizenship
Must be able to pass a background screening
*Legitimate correspondence for this position will only come from @JYGInnovations.com or from ISolved
JYG Innovations is committed to hiring and retaining a diverse workforce. JYG Innovations is an equal opportunity/affirmative action employer and does not discriminate on the basis of race, color, creed, sex, national origin, religion, age, disability, pregnancy or veteran status. We welcome the employment of women, minorities, veterans and individuals with disabilities in our workforce. If you are in need of special assistance, please contact our Human Resources Department. Interested parties may view our Affirmative Action Plan for Veterans and Individuals with Disabilities by contacting the Human Resources Department. JYG Innovations participates in E-Verify.
