Job Type Full-time Job Title Credentialist Job Description
*** THIS POSITION IS CONTINGENT UPON CONTRACT AWARD ***
The Kansas Army National Guard Medical Detachment requires Credentialist and Medical Record Technician services to support the assessment of the medical readiness of Army National Guard personnel. Credentialist must be fully capable of physically conducting basic administrative actions including record keeping, spreadsheet development, active communication, deadline tracking and use of all electronic systems with the ability to be certified and/or qualified through any Government Security or Validation program as needed to conduct the required services. Duties include, but are not limited to:
Data Entry into the following systems: Medical Operational Data System (MODS), MEDPROS, MWDE, JCCQAS.
Reports to the Chief of Medical Staff or Deputy State Surgeon
Serves as the technical advisor to the Privileging Authority, Credentials Committee/Function Chairperson, and assigned providers on issues related to the Credentialing and Privileging (CP) Program to include at least: appropriate procedures in accordance with DHA-PM 6025.13, Volume 4 and other directives; accrediting organization (AO) standards; and applicable federal, state, and other mandated regulatory guidance.
Coordinates and implements written policies and procedures applicable to all aspects of the CP Program and all other Clinical Quality Management (CQM) Programs, as appropriate.
Ensures providers’ identification are verified by viewing, and obtaining a copy of, a current valid picture identification issued by a federal or state agency, such as a driver’s license, military identification card, or passport.
Provides technical management, verification and assessments regarding credentials information; processes privileging and medical staff appointment applications; and monitors and tracks licensure, certification and registration status for all privileged providers, as outlined in DHA-PM 6023.13, Volume 4, and for all nonprivileged providers as directed by the Chief of Medical Staff or Deputy State Surgeon. Must also ensure evidence exists in the credentials file that establishes the authority by which a non-governmental employee may be granted privileges by the Privileging Authority (e.g., volunteer agreement, information from the Contracting Officer, other).
Collaborates with Clinical Directors/Department Heads to identify, collect, track, trend, and analyze ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE). Facilitates departmental compliance with ongoing monitoring of the medical staff for Credentials Committee/Function review and for recommendations to the Privileging Authority for re-privileging.
Supports the Impaired Healthcare Provider Program as per DHA-PM 6025.13, Volume 3, if/as applicable.
Provides support to Reserve Medical Unit Credentials Committee/Function as needed and as applicable.
Serves as point of contract for fee-exempt Drug Enforcement Administration (DEA) registration and National Provider Identifier (NPI) Type 1 registration.
Serves as the Privileging Authority’s JCCQAS database administrator authorizing user access, education, and training on new CP procedures, processes, and policies.
Establishes and maintains current information in the JCCQAS electronic database including co-located units and other assigned military personnel, as needed (i.e., Individual Mobilization Augmentees [IMAs]). Maintain all required credentialing and privileging documentation in the provider’s credentials record relating to clinical performance.
Initiates the credentialing, privileging, and medical staff appointment process. Performs a comprehensive data quality and risk assessment review of the electronic Provider Credentials File and ensures documents are scanned, named in accordance with the standard naming convention, and uploaded to the provider’s credentials record.
Performs relevant National Practitioner Data Bank (NPDB) queries, other applicable queries, and Primary Source Verifications (PSV). Performs risk assessment and authenticates the credentials of privileged medical staff members applying for initial clinical privileges and appointment to the medical staff or other changes in privileges as appropriate. Per the Chief of the Medical Staff/Deputy State Surgeon, assures compliance with validation of non-privileged providers’ credentials, as well as relevant NPDB queries, other applicable queries, and PSV upon in-processing to the organization and with other changes in practice as appropriate.
Maintains a system for internal staff to properly identify healthcare providers practicing at the organization, and to confirm clinical privileges or clinical scope of practice.
Provides ongoing JCCQAS reports on expiring credentials (at a minimum of quarterly), to the Chief of the Medical Staff/Deputy State Surgeon and Credentials Committee/Function.
Serves as point of contract for release of information regarding clinical privileges/practice for healthcare providers who have, or previously had, an affiliation with the organization.
Establishes and supports the creation of the provider profile within the electronic health record (EHR) system in collaboration with the health information technology office to provide access to the EHR upon appropriate credentialing and privileging of healthcare providers.
Ensures protection of and access to Medical Quality Assurance Program material is in accordance with Section 1102 of United States Code, Title 10.
Initiates annual system reviews to identify, analyze, and determine facility and resource capabilities that may impact safe and reliable healthcare of the force. At intervals not to exceed 12 months, a review of facility-specific departmental criteria with appropriate department heads, Credentials Committee/Function is required to ensure criteria are appropriate to support the granting of clinical privileges. The local Master Privilege List (MPL) must reflect facility capabilities.
Performs Medical Records Technician duties when not performing credentialing duties
High School Diploma or equivalent. Associates Degree desired
Minimum 2 years’ experience as a Medical Staffing Credentialist
Must be able to multi-task, be detail-oriented, be organized and have excellent verbal and communication skills
Previous experience with Medical Records desired
Previous experience working with DoD and Army policies and procedures desired
Previous experience with the use of several DOD web-based electronic data systems; (e.g. Medical Operational Data System (MODS), Medical Electronic Data for Care History and Readiness Tracking (MEDCHART), Joint Centralized Credentialing Quality Assurance System (JCCQASP), and MILPDS preferred
Proficiency with computer and common office equipment, as well as with MS Office products required.
Must be willing to travel to other Kansas Army National Guard locations if required.
Location Lenexa, KS - Lenexa, KS 66219 US (Primary) Category Medical
General-Other: Human Resources, General-Other: Medical-Health
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