Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

The Medical Staff Services (MSS) database administrator will be responsible for design, development, and implementation of database applications for MSS.  This role will manage system updates, perform ongoing maintenance, evaluate and implement database enhancements and/or software, navigate complex problems, and work closely with vendor and internal resources to ensure the integrity of the database and the contained within.  The MSS database administrator will work independently to provide technical, business analysis, and/or project leadership in designing and/or implementing credentialing automation, integration and re-engineering for MSS in collaboration with other stakeholders.   

The Credentialing Specialist is accountable for completion of initial appointment/reappointment, credentialing, and privileging, following regulatory requirements to ensure compliance and safety for patients and the health system.

• Responsible for system administration of the credentialing database, granting system access and report access to appropriate users or groups of users.  
• Reviews and evaluates current systems to increase database efficiency and usability. 
• Troubleshoots database issues, coordinating with the vendor and Health Information Technology Services (HITS) as needed. 
• Maintaining ongoing sanctions reviews and log to meet health plan audit requirements for MSS.
• Participates in the planning, development, implementation, and monitoring of systems within MSS credentialing platform.
• Contributes to the planning, development, and implementation of MSS related computer applications.
• Supports, updates and modifies existing MSS computer applications.
• Possesses knowledge of databases, servers, and other data management used in computer application build.
• Assists with gathering information by coordinating with individual team members to produce team measurements, quality statistics and team improvement efforts.
• Acts as a liaison with internal and external partners.
• Maintains involvement in local/regional and national professional organizations and maintains a current knowledge of key trends in the healthcare environment. Responsible for maintaining an appropriate MSS work environment to support the operation in accordance with external regulations and requirements.
• Serves as a liaison between users and HITS/technical support staff that support MSS applications.
• Perform daily system monitoring, verifying the integrity and availability of system processes.
• Perform data validation testing, password management functions, create, change, and delete/deactivate user accounts per request.
• Perform on-site and remote system support.
• Uses technical and application knowledge to create specifications for changes, new functionality, and report requests.
• Develops routine report generation and pulls data as needed to facilitate the efficient and effective operations of MSS.
• Track operational metrics by institution, a specific facility location, or a provider.
• Enhance workflow, allowing for the generation of work lists and follow-up requirements.
• Meet credentialing requirements from the Joint Commission and the National Committee on Quality Assurance (NCQA).
• Develop easy-to-understand interface, with a dashboard, graphics, and drag-and-drop capabilities.

20% of this role maintains credentialing and privileging responsibilities. 

• Identifies red flags during the credentialing and privileging process with authority to halt the process until the issue has been resolved, and is empowered, using strong analytical skills and judgment, to resolve locally or determine if the issue should be escalated. The credentialing specialist autonomously conducts the final analysis meticulously before deeming the credentialing packet as complete and ready for committee review and Board approval.
• Conducts all primary source verification necessary to complete the credentialing and privileging process maintaining standards by policies and procedures, rules and regulations, and accreditation requirements. Through delegated credentialing contracts, the credentialing specialist completes this work on behalf of each contracted plan, leveraging the contracts to expedite enrollment and reimbursement.
• Using expert knowledge, creativity, and ingenuity, identifies and implements ideas for process improvement using LEAN tools and strategies, wherever possible, keeping within the confines of the rules, regulations, and accreditation requirements to develop a more efficient process while still providing a safeguard to the institution.
• Applies broad knowledge and ability in interpretation and dissemination of policies, procedures, and process/rules/regulations/law changes, concerning credentialing and re-credentialing for practitioners at UMH-AMC.
• Ensure regulatory and accreditation agencies' readiness with contracted health plans, triennial and biennial Joint Commission surveys for both routine and disease-specific certifications, ad hoc CMS, and State of Michigan surveys.
• Maintains the confidentiality of credential information, exercising due caution and discretion in responding to inquiries for information.
• Maintains and protects the integrity of the credentialing database as the source of truth for privileged provider information throughout the health system's various IT systems such as the electronic health record, online provider directory, and billing system. Ensures database accuracy so that Provider Enrollment can complete health plan enrollment.
• Management and maintenance of expirables such as licenses, certifications, and other credentials to maintain compliance with State law, policies, and procedures.
• Clearly and accurately presents complicated and exacting information regarding credentialing, re-credentialing, and privileging to the clinical departments, providers, and institutional stakeholders.
• Responds to inquiries and complaints regarding matters of a sensitive or confidential nature, exercising initiative, independent judgment, and diplomacy, with an excellent customer service-oriented attitude.

• Bachelor's degree or relevant education and experience
• 1-2 years' experience as a credentialing specialist or credentialing coordinator.
• Related database experience, including development of queries and reports 
• LEAN training or complete LEAN training within 3 months of hire.
• Demonstrated excellent interpersonal, problem-solving and communication skills, both written and oral.
• Excellent organizational and multi-tasking skills.
• Strong record of working effectively, cooperatively, and professionally with a diverse group of faculty and staff, and aid in the training and education of all existing and new staff.
• Ability to commit to and meet deadlines, while not compromising quality 
• Outstanding verbal and written communication skills, as well as advanced organizational skills

• 3-5 years of credentialing and privileging experience.
• CPCS certification.
• Knowledge of hospital or clinical department policies and procedures.
• Knowledge of the sProvider credentialing application and/or implementation of credentialing applications
• Previous experience in training facilitation, mentoring, or development of instructional materials 
• Possess an understanding of accreditation requirements (TJC, NCQA, CMS, etc.) and delegated credentialing.

Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world?s most distinguished academic health systems.  In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

What Benefits can you Look Forward to?

• Excellent medical, dental and vision coverage effective on your very first day
• 2:1 Match on retirement savings

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled any time after the minimum posting period has ended.

The University of Michigan is an equal employment opportunity employer.