Position: Privileging Specialist

Monogram Health is seeking a skilled Credentialing Specialist to support and facilitate external hospital and facility privileging and affiliations tied to strategic organizational initiatives.

This role is part of a new internal service offered through the Licensing and Credentialing (L&C) Department. We have an opening for a remote, self-directed, and experienced medical staff services professional with a talent for in-depth research and learning quickly. This role requires strong knowledge of hospital credentialing practices, hospital affiliation levels, and specialized privileging requirements.

The primary responsibility for this role will be to submit medical staff applications to hospital and healthcare facilities, ensuring practitioners meet all required standards, and follow up with the appropriate medical staff organization contact until completion. The Specialist will serve as an in-house subject matter expert and assist management in developing best practices in compliance with state, regulatory and accrediting body standards.

This role will involve communication of status to executive leadership, advising on projected timelines while navigating and escalating roadblocks as needed. The Specialist will perform all tasks associated with medical staff initial appointments and reappointments, working closely with clinicians to obtain necessary information and documentation for successful application submissions.

Ideal Background: Prior experience in roles such as Privileging Specialist, Medical Staff Services Coordinator, Medical Staff Services Specialist, Credentialing Verifier, Credentialing Specialist, Credentialing Account Manager, Credentialing Team Lead, Medical Staff Office Professional, Provider Enrollment Specialist, Provider Enrollment Account Manager, Provider Enrollment Team Lead is beneficial.

Traits for Success: Ideal candidates are investigative, adaptable, self-motivated, detail-oriented, process-driven, accuracy focused, deadline-conscious, and strategic. Strong documentation skills and organizational abilities are essential.

Roles and Responsibilities

• Prepare and submit accurate, complete medical staff and privileging applications to hospitals and affiliated healthcare facilities.
• Maintain active follow-up on submitted applications, coordinating with facility credentialing departments to track application process and expedite approvals. Document status and enter notations into credentialing platform. Pull system reports to manage daily workflow and priorities.
• Use expertise in hospital affiliation levels and privileging nuances to tailor applications to specific facility requirements and standards. Complete ad hoc privileging research requests for organizational strategic initiatives.
• Act as the primary point of contact between Monogram Health and hospital credentialing offices, maintaining clear and proactive communication regarding application status, outstanding items, and follow-up needs and roadblocks.
• Keep organized records of application submissions and supplemental documents in credentialing software and local drives. Understands the importance of maintaining accurate notes in the credentialing software so that details of the process, issues encountered, and time metrics can be generated as needed for context, future projections and KPM's.
• Ensure that all submitted applications align with regulatory standards, organizational policies and the unique criteria of each facility.
• This role is volume-dependent, with workload variations based on market expansion and internal business needs. The Specialist will also provide backup support for payor enrollment and internal credentialing as needed. Cross-training will be provided by management.

Position Requirements

• 3 + years in medical staff services or a similar role focused on privileging, hospital affiliations, or credentialing support experience required
• Bachelor's degree preferred; certification as a Certified Provider Credentialing Specialist (CPCS) or Certified Professional in Medical Services Management (CPMSM) is a plus
• Familiarity with credentialing software, proficiency in Microsoft Office applications, particularly Excel and Word Microsoft as well as and Adobe Acrobat and Adobe DocuSign
• Strong understanding of hospital credentialing, affiliation levels, and privileging standards to facilitate accurate and efficient application submissions.
• Knowledge of NCQA and Joint Commission credentialing requirements
• Strong research skills and the ability to draw conclusions from data.
• Skilled in managing multiple application processes simultaneously, ensuring that all submissions are well-documented and on track for completion.
• Able to engage with hospital credentialing departments and Monogram Health colleagues effectively, fostering strong working relationships and clarity on application statuses.

Benefits

• Opportunity to work in a dynamic, fast-paced and innovative care management company that is transforming the delivery of kidney care
• Competitive salary and opportunity to participate in company's bonus program
• Comprehensive medical, dental, vision and life insurance
• Flexible paid leave & vacation policy
• 401(k) plan with matching contributions

About Monogram Health

Monogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram seeks to fill systemic gaps and transform the way nephrology, primary care and chronic condition treatment are delivered. Monogram's innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease.

At Monogram Health we believe in fostering an inclusive environment in which employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams, and welcome those from all backgrounds and varying experiences.