Credentialing Supervisor
Responsibilities:
- Provide a wide breadth of practitioner credentialing and verification support that includes obtaining and verifying sensitive information.
- Provide oversight and quality analysis of database entry.
- Prepare critical information and submit via ballot and meetings to Subpanel, Medical, Surgical and Ad Hoc committees, to grant and reaffirm privileges to UIHC practitioners.
- Collect and compile data for credentialing reports, credentialing committee report and CSO reports from University department administrators, practitioners and other institutions. Compare collected credentialing information against specific criteria and determines levels of compliance.
- Query background checks.
- Add, update and query National Practitioner Data Bank.
- Monitor the trending and oversee the process of Wellmark Welcome Letters.
- After Clinical Staff Office review committee meetings, prepare and distribute approval letters. Provide backup to send compiled practitioner information to Managed Care Companies to ensure proper loading for reimbursement.
- Monitor license sanctions to be reported to the Continuous Quality Improvement Committee (CQIC).
- Review practitioner information daily to meet established guidelines from NCQA, JC, and CMS to report to managed care payers.
- Provide back-up for interim monitoring, the managed care review committee and Hospital Advisory committee for privileges.
Education/Background:
- Kirkwood Community College Practical Nursing 1977
- University of Iowa BBA 1984
- Basic and Advanced Credentialing El Centro College 2012
- Certified Provider Credentialing Specialist 2015
- Member of Iowa Association Medical Staff Service since 2012
- Member of National Association Medial Staff Services since 2014
Special Interests/Hobbies:
Travel, Reading, baking and spending time with family and friends and pets.
Contact:
Address: C123 GH
Phone: 319-384-9295
doris-baxter@uiowa.edu
When asked, “What inspires you?”
“Optimism inspires me. Quotes like, Yesterday is history. Tomorrow is a mystery. Today is a gift. That’s why we call it the present. —Bil Keane”