Responsible for serving as an essential link and resource between senior management and medical staff to coordinate the operational processes and ongoing credentialing, privileging, and medical staff governance functions of the Office of Clinical Affairs. Reviews, analysis and follows up credentialing and privileging applications, maintaining strict confidentiality and ensuring compliance with organizational policies and accrediting and regulatory agencies.


Principal Accountabilities:


1. Assists in the management of the medical staff support function for the entity Medical Staff Organization as outlined in the entity Medical Staff Bylaws.
2. Coordinates receipt of credentialing and privileging applications following processing and primary source verification by the UNM Health System Credentialing Verification Office (CVO); performs review and analysis, identification and follow up of "red flag" items; prepares files for review and recommendation by the medical staff.
2. Coordinates credentialing end-of-committee process to ensure notification of providers, departments and CVO; database updates; breakdown, completion and scanning of files as appropriate.
3. Schedules, coordinates, prepares agenda, takes minutes, provides follow up for medical staff committees outlined in the entity Medical Staff Bylaws.
4. Prepares summary reports of credentialing/privileging recommendations and ensures flow of information and action items for medical staff committees outlined in the entity Medical Staff Bylaws.
5. Assists in coordination, tracking and monitoring of the OPPE and FPPE process ensuring compliance with regulatory standards and Medical Staff Affairs policies.
6. Interprets federal, state, local, and government/insurance agency regulations and guidelines, as well as University, Medical Staff Bylaws, rules and regulations, policies and procedures; advises providers, management, and administrators on compliance issues as appropriate.
7. Generates queries and reports from credentialing and privileging database.
8. Assists with clinical privilege development and maintenance of the entity privilege database.
9. Performs other related duties as assigned.