Credentialing Specialist

Under the general supervision of the Medical Staff Governance and Credentialing Manager and the Director of Regulatory, Licensure & Accreditation and Medical Staff Governance & Credentialing, the Credentialing Specialist is an experienced professional responsible for independently managing complex credentialing and privileging activities for medical staff and advanced practice professionals at UC Davis Health. The position applies advanced knowledge of credentialing and privileging theory, regulatory requirements, medical staff policies, and applicable standards to evaluate the clinical qualifications of providers and ensure that practitioners are appropriately credentialed and privileged to provide patient care.

The position has primary responsibility for managing the full range of credentialing and privileging activities, including the evaluation and processing of applications and supporting documentation and serving as the primary liaison for applications presented to the Credentials and Privileges Committee, Medical Staff Executive Committee, and Governing Body. The Credentialing Specialist works independently with minimal supervision and is expected to exercise considerable judgment, analytical ability, organization, and problem-solving skills in addressing complex credentialing and privileging issues. The position serves as an experienced resource and organizational liaison among medical staff members, the Chief Medical Officer, Academic Personnel, clinical departments, and patient care areas.

The position also provides technical expertise related to the Credential Stream credentialing database and represents UC Davis Health as an experienced credentialing and privileging professional during reviews and inquiries conducted by regulatory, accrediting, governmental, health plan, and University entities.

Apply By Date: September 6, 2026, at 11:59 PM

Minimum Qualifications - For full consideration, applicants are encouraged to upload a license and/or certification if required for the position.

• Completion of applicable NCQA credentialing education/training or equivalent demonstrated experience and knowledge of NCQA credentialing standards
• Several years of experience in medical credentialing or similar equivalent roles
• Experience applying NCQA credentialing standards and credentialing-integrity requirements in practitioner credentialing, primary-source verification, recredentialing, ongoing monitoring, documentation, and audit readiness
• Knowledge and understanding of Credentialing and Privileging principles and theories
• Skills to independently apply external regulatory guidelines dictated by California and Federal law and regulatory agency standards about credentialing in the healthcare industry (i.e., CMS, Title 22, The Joint Commission, NCQA and/or other accrediting bodies) and internal administrative policies
• Critical thinking, research, investigatory, and analytical skills to solve problems and propose solutions through the critical thinking process
• Knowledge and skills to assess and monitor credentialing theory, compliance, and effectiveness of credentialing and privileging processes
• Knowledge of medical terminology and medical and surgical procedures
• Skills to independently set and meet deadlines while multitasking, assigning precedence to competing priorities, to see multiple assignments through to completion on deadline and according to organizational goals. Skills to work collaboratively
• Skills to coordinate and integrate with others throughout the department, hospital, and campus
• Skills to communicate through all mediums and with all groups; often working under pressure of constantly changing deadlines and priorities
• Excellent verbal and written communication skills
• Thorough knowledge of data management and documentation methods used in medical credentialing
• Demonstrated computer and database knowledge, along with MS Office proficiency and ability to effectively use the credentialing database application

Preferred Qualifications

• Certification as a CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional in Medical Services Management)
• Completion of NCQA credentialing education/training applicable to the organization's credentialing program
• Experience maintaining documentation and audit trails sufficient to support NCQA accreditation/certification and internal credentialing audits
• Knowledge of credentialing integrity and compliance practices, including maintaining accurate, complete, current, and confidential practitioner credentialing records
• Ability to identify credentialing discrepancies, gaps, and compliance issues and ensure timely resolution

Key Responsibilities

• 70% - Credentialing and Privileging
• 30% - Computer Database Management and Analysis

Department Overview

Medical and Regulatory Affairs has overall responsibility for the management and oversight of the credentialing and privileging process at UC Davis Health. The department supports the quality and safety of patient care by ensuring that physicians, dentists, clinical fellows, nurse practitioners, psychologists, and other advanced practice professionals meet established qualifications and regulatory, organizational, and medical staff requirements for participation in patient care.

Through formal, technical, and rigorous credentialing and privileging processes, Medical and Regulatory Affairs
evaluates the education, training, experience, clinical qualifications, professional history, and other relevant information necessary to determine whether practitioners are qualified to provide specific patient care services.

The department works collaboratively with medical staff leadership, clinical departments, Academic Personnel, hospital leadership, patient care areas, and other internal and external stakeholders to maintain compliance with applicable regulatory and accreditation requirements and to support the ongoing quality and safety of patient care.

Department Specific Job Scope

The Medical Staff Services Specialist 3 independently manages complex credentialing and privileging functions and serves as an experienced professional resource within Medical and Regulatory Affairs. The position is responsible for evaluating the clinical qualifications of providers and applying credentialing and privileging requirements to a diverse population of medical staff members and advanced practice professionals.

POSITION INFORMATION

• Salary or Pay Range: $2,521.07 - $4,421.46
• Salary Frequency: Bi-weekly
• Salary Grade: 20
• UC Job Title: MED STF SVC SPEC 3
• UC Job Code: 005519
• Number of Positions: 3
• Appointment Type: Career
• Percentage of Time: 100% Full-Time
• Shift (Work Schedule): Monday -Friday (8 AM to 4 PM)
• Location: North Addition Office Building, Sacramento, CA
• Union Representation: Non-Represented (PPSM)
• Benefits Eligible: Yes
• This position is hybrid (mix of on-site and remote work): Upon successful completion of the initial training period, the position is eligible to work remotely one (1) day per week.

Benefits

Outstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources, and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial, and career goals. Learn more about the benefits below and eligibility by visiting or or .

• High-quality and low-cost to choose from to fit your family's needs
• UC pays for and coverage for you and your family
• for eligible employees, including Pension and other Retirement Saving Plans
• Supplemental insurance offered including , , , , accident, critical illness and hospital indemnity
• , , and for eligible employees
• and Family Care discounts and resources
• to support thriving in all aspects of employees' lives
• On-site including access to free mental health services
• Generous amount of paid Holidays annually as outlined in the UC Policies or Collective Bargaining Agreements
• Paid Time Off/Vacation/Sick Time as outlined in the UC Policies or Collective Bargaining Agreements
• Continuing Education (CE) allowance and Staff Education Reimbursement Program for eligible employees
• Access to free professional development courses and learning opportunities for personal and professional growth
• an