Manager, Centralized Verification Organization - Onsite

Adventist Health•Roseville, CA

2d•Onsite

About The Position

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Manages Centralized Verification Organization's (CVO) credentialing operations. Manages and monitors workflow design, work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution. Evaluates performance and makes recommendations for personnel actions. Motivates employees to achieve peak productivity and performance.

Requirements

Bachelor's Degree in business, information management, health administration or related field or equivalent combination of education/related experience: Required
NAMSS Certified Provider Credentialing Specialist (CPCS): Required
NAMSS Certified Professional Medical Services Management (CPMSM): Required within 2 years of employment
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.

Nice To Haves

Master's Degree: Preferred
Five years' relevant experience: Preferred
One year's leadership experience: Preferred

Responsibilities

Manages Centralized Verification Organization's (CVO) credentialing operations.
Manages and monitors workflow design, work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution.
Evaluates performance and makes recommendations for personnel actions.
Motivates employees to achieve peak productivity and performance.
Acts as subject matter expert as a solution driven leader with focus on streamlined processes and the provider experience.
Monitors and manages turnaround times for processing of credentials applications and has overall accountability for focus on delivery of a high quality product, with the greatest efficiency, in the least amount of time.
Ensure expirables (licenses, DEAs, malpractice coverage, etc.) are kept current and ongoing monitoring is conducted, and status is reported to markets.
Manages and reports operational metrics.
Ensures that the CVO achieves and maintains NCQA certification including leading the biannual survey effort.
Maintains strong knowledge of regulatory body requirements that include The Joint Commission (TJC), California Department of Health (CDPH), Centers for Medicare & Medicaid Services (CMS), and the National Committee on Quality Assurance (NCQA).
Develops and reviews CVO operating policies and procedures, and delegates credentialing policies and procedures.
Develops, recommends, and/or implements changes, revisions, and enhancements as appropriate.
Maintains strong customer relationships with market leaders, and ensures their understanding of their role in the credentialing process.
Performs other job-related duties as assigned.