Medical Privileging and Credentialing Expert

1 week ago

Washington, Washington, D.C., United States Blue Water Thinking Full time

About Blue Water Thinking

We are a values-driven organization that proudly supports our Federal clients in achieving their Agency goals.

Founded by a decorated Veteran of the United States Army, we understand and support the mission of our Nation's war fighters, Veterans, their families and caretakers.

Leveraging our executive team's military experience and private and public sector consulting expertise, we take an integrated approach to bring best-fit solutions and thought leadership to meet our client's transformational needs.

Our formula for success is built on integrity, respect, professionalism, stewardship and customer service. We believe in the power of human connection, collaboration, humility and loyalty to one another, our clients and industry partners.

Job Description

We seek an experienced Medical Privileging and Credentialing Expert to join our team, supporting a large project at the Department of Veterans Affairs (VA). The primary responsibility of this role is to perform credentialing and privileging tasks, including enrollment, primary source verifications, privileging support, and managing healthcare practitioner records.

Key Responsibilities:

  • Perform credentialing and privileging tasks such as enrollment, primary source verifications, and maintaining healthcare provider records.
  • Assist with the privileging process, ensuring compliance with VA Medical Staff Bylaws.
  • Correspond with healthcare practitioners regarding credentialing and privileging status and requirements.
  • Conduct reporting to State Licensing Boards and the National Practitioner Databank as required.
  • Review and interpret National Practitioner Databank reports and ensure accurate documentation in compliance with VHA standards.
  • Utilize VHA VetPro systems to manage and track credentialing activities.
  • Collaborate with healthcare practitioners to complete credentialing applications and ensure timely submission.
  • Ensure compliance with all applicable laws, regulations, and VA policies related to credentialing and privileging processes.
  • Support onboarding processes, ensuring credentialing and privileging steps are completed efficiently and coordinating and tracking submission of VA staff onboarding documentation.

Requirements

  • Bachelor's Degree.
  • 2+ years of relevant experience as a credentialing and privileging specialist, with current experience within the VHA (separation within the last two years).
  • Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional Medical Services Management (CPMSM) certification from the National Association of Medical Staff Services (NAMSS).

Preferred Qualifications:

  • Experience in federal contracting, particularly with the Department of Veterans Affairs (VA).
  • Experience using VHA VetPro systems for credentialing and privileging processes.
  • Knowledge of Medical Staff Bylaws and compliance with state and federal regulations.
  • Strong understanding of National Practitioner Databank and State Licensing Board reporting.

Compensation:

The estimated salary for this position is $65,000 - $75,000, depending on factors such as location and qualifications.

We offer a comprehensive benefits package, including health insurance, paid time off, federal holidays, and a matching 401K plan.

Equal Opportunity Employer:

We are committed to diversity and inclusion, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, marital status, disability, veteran status, sexual orientation, genetic information, or any other protected status.

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