Job Description

Under general supervision of the Director of the Medical Staff Services Department (MSSD) Office of Compliance & Privacy Affairs (OCPA), Behavioral Health Services Compliance Office (CHSCO) Compliance Officer, the Medical Staff Services Department Specialist performs the following essential job functions:

• Receives and processes initial and updated requests for credentialing/verification from provider staff and coordinates the request with related IT staff.
• Uses software systems and paper forms to create initial and updated application packets for Medical/Affiliated Staff and subsequently, processes the completed applications; verifies education, training, experience, clinical competence, licensure and professional liability history and peer review; creates and maintains documentation into confidential credentials folder; answers routine questions relating to the application/documentation process; assists with the monitoring of clinical privileges for the Medical/Affiliated Staff.
• Uses software, database and spreadsheet software to generate, summarize and report provider enrollment/credentialing/verification information for monitoring and reporting purposes.
• Assists in the development of staff training materials, standard work protocols, and policies and procedures that serve to ensure consistency in the review, analysis and reporting of provider enrollment and credentialing information.
• Provides consultation, communication and guidance to provider staff and administrators on management of provider enrollment and credentialing/verification processes.
• Reads and analyzes guidance by external regulatory agencies or internal policy changes to identify impacts to Compliance.
• Maintains awareness and knowledge of current standards and policies related to: credentialing, verification and provider enrollment processes for Medicaid, Medicare and other federal insurance programs

The 2106 Medical Staff Services Department Specialist also performs other related duties as required.

Qualifications

Minimum Qualifications - Required

• ** EXPERIENCE : One (1) year of verifiable experience in a Medical Staff Services Department or similar department**

Note: Medical Staff Services Department or similar department must be responsible for medical staff credentialing, payer credentialing, health plan enrollment, medical staff governance, or other related functions.

AND

• ** LICENSE AND CERTIFICATION : Possession of a current certificate or eligibility to be a candidate for the Certified Provider Credentialing Specialist Certificate (CPCS) or Certified Medical Staff Coordinator Certificate (CPMSM) examinations sponsored by the National Association of Medical Staff Services (please attach to your application)**

The above minimum qualifications reflect special conditions associated with the position(s) to be filled. They may differ from the standard minimum qualifications associated with this classification.

Applicants must meet the minimum qualification requirement by the final filing date unless otherwise noted.

One-year full-time of employment is equivalent to 2,000 hours (2,000 hours of qualifying work experience is based on a 40-hour work week).

Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this recruitment or future job opportunities.

Additional Information

Selection Procedures :
After application submission, candidates deemed qualified must complete all subsequent steps to advance in this selection process, which includes the following.

Assessment Component
Candidates that meet the minimum qualifications will be invited to participate in Supplemental Questionnaire exam that is designed to measure the knowledge, skills, and abilities in job related areas which may include but not be limited to: Knowledge of Medical Staff credentialing and concepts; Knowledge of requirements of state and federal laws and statutes; Knowledge of procedures for recording and transcribing Medical Staff committee minutes; Organizational skills; Oral communication ability; Personal computer skills; and/or Interpersonal relation skills.

Supplemental Questionnaire Examination (Weight: 100%): Candidates must achieve a passing score on the supplemental questionnaire exam in order to continue in the selection process and will be placed on the confidential eligible list in rank order according to their final score.

Additional selection processes may be conducted by the hiring department prior to making final hiring decisions.

Certification
The certification rule for the eligible list resulting from this examination will be the Rule of the List Scores.

Eligible List/Score Report :
Once you pass the exam, you will be placed onto an eligible list and given a score and a rank. For more information, visit https://careers.sf.gov/knowledge/process/

The duration of the eligible list resulting from this examination process will be 6 months and may be extended with the approval of the Human Resources Director.

How to apply:
Applications for City and County of San Francisco jobs are only accepted through an online process. Visit careers.sf.gov and begin the application process.

Our e-mail communications may come from more than one department so please make sure your email is set to accept messages from all of us at this link.

Applicants may be contacted by email about this recruitment therefore, it is their responsibility to contact the Analyst if they update their email address.

Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received.

Terms of Announcement and Appeal Rights:

This is a Position Based Test (PBT) administered in accordance with Civil Service Rule 111A.

Applicants must be guided solely by the provisions of this announcement, including requirements, time periods and other particulars, except when superseded by federal, state or local laws, rules or regulations. Clerical errors may be corrected by the posting the correction on the Department of Human Resources website at https://careers.sf.gov/. The terms of this announcement may be appealed under Civil Service Rule 111A.35.1. The standard for the review of such appeals is ‘abuse of discretion’ or ‘no rational basis’ for establishing the position description, the minimum qualifications and/or the certification rule. Appeals must include a written statement of the item(s) being contested and the specific reason(s) why the cited item(s) constitute(s) abuse of discretion by the Human Resources Director. Appeals must be submitted directly to the Executive Officer of the Civil Service Commission within five business days of the announcement issuance date.

Additional information regarding Employment with the City and County of San Francisco:

• Information about the Hiring Process
• Conviction History
• Employee Benefits Overview
• Equal Employment Opportunity
• Disaster Service Workers
• Reasonable Accommodation
• Right to Work
• Copies of Application Documents
• Diversity Statement
• Veterans Preference

If you have any questions regarding this recruitment or application process, please contact the analyst, Herbert Chau at herbert.chau@sfdph.org or (628) 271-6707.

We may use text messaging to communicate with you on the phone number provided in your application. The first message will ask you to opt in to text messaging.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.