Credentialing Specialist

Summary

This Credentialing Specialist position is located within the Indian Health Service, Chinle Service Unit, Division of Clinical Services, in Chinle, Arizona. The position ensures medical doctors, independently licensed practitioners, and non-physician providers meet credentialing requirements established by Service Unit Medical Staff Bylaws, government regulations, and accrediting agency standards. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).

Duties

Manages credentialing and privileging for Medical and Dental Staff, Licensed Independent Practitioners, non-physician providers, residents, fellows, students, and volunteers; prescreens applications, verifies qualifications, licensure, competency, and required Indian Health Service documentation, and ensures privileges align with training and experience. Ensures compliance with applicable regulatory, accreditation,and facility requirements; monitors appointments, reappointments, temporary and modified privileges, and maintains accurate, confidential records with timely expiration notifications. Conducts background research and primary-source verification of references, hospital affiliations, licensure, disciplinary actions, suspensions, revocations, and privilege restrictions; performs investigations as directed and verifies qualifications before review. Coordinates credentialing, privileging, and appointment processes, including background clearances, affiliation and privilege verification, additional privilege requests, supporting documentation, and appointment and reappointment lists; ensures compliance with Medical Staff Bylaws and policies. Manages automated systems to track expirations, appointments, privileges, peer reviews, and provider access; coordinates provider rotations, enrollment, background clearances, system access, housing, and orientation with appropriate departments. Identifies and coordinates technical services, supplies, equipment, professional references, journals, and other resources needed to support program operations; provides technical assistance to supervisors, and preparing materials and presentations.

Qualifications

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS: GS-07: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Performing and coordinating established credentialing processes. Processes credentialing and privileging applications, reviews provider qualifications and required documentation, verify licenses and clinical privileges, maintain confidential records, tracks appointments and expirations, coordinates background clearances, and prepares reports and files for committee review. Providing administrative and technical support to medical staff leadership. OR One full year of graduate level education or superior academic achievement. GS-09: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least GS-07 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Independently reviewing and analyzing applications using judgment and exercising responsibility in credentialing and privileging activities. Reviews complex provider applications and qualifications, applies credentialing standards, bylaws, regulations, and accreditation requirements, conducts primary-source verification and investigations, evaluates adverse actions and competency, and prepares recommendations for Medical Executive Committee and Governing Body review. Provides technical guidance and recommendations to medical staff leadership regarding credentialing and privileging requirements. OR Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D., if related. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP).

Education

If you are substituting education for experience; You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer. Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit https://sites.ed.gov/international/recognition-of-foreign-qualifications/.