Supervisor, Centralized Operations Unit

UCSF•San Francisco, CA

11d•$84,500 - $179,300

About The Position

The supervisor has various duties and responsibilities working within a high volume, goal-driven environment (estimated target: 75 to 100 files per week across a team), contributes to the overall productivity of the Centralized Processing team by directly supervising 3 - 6 staff members responsible for using medical staff credentialing and provider payer enrollment techniques, workflows, and best practices. Implements credentialing and health plan payer enrollment function processes and monitors assigned staff compliance. Auditing files for completion, monitoring results, and gaining/sustaining stakeholder buy-in. Initiates and cultivates partnerships with other members of the Centralized Processing team, department management, medical staff /hospital/health plan/payor leadership and information technology teams to ensure compliance and optimal efficiency for appropriate membership for UCSF Medical Staff, Advanced Practice Professionals and CVO contracted facilities (LPPH&C, School of Dentistry and others, as applicable), and important responder to data integrity/system interface issues, primary source credentialing information, onboarding and revenue channel disruptions as well as performs auditing functions pursuant to facility Bylaws, Rules and Regulations; Credentialing Policy and Procedures; and other applicable accreditation/payor standards (e.g. NCQA, TJC, DHS, DMHC, CMS, delegated credentialing agreements, etc.). This role includes responsibilities and involvement in the department’s engagement, educational, and professional development activities (i.e. Staff Engagement Committee, Education & Development Committee, Diversity, Equity, and Inclusion Committee, etc.) to achieve department and organization goals/work plans. Facilitator of team meetings, preparation of agendas and related materials for team huddles, medical staff meetings, and peer review activities. Monitors compliance with medical staff bylaws, provider enrollment requirements, rules, regulations, policies, and procedures. Interprets and develops policy and procedures, and manages training and orientations to a variety of constituents to sustain best practices.

Requirements

Working within a high volume, goal-driven environment (estimated target: 75 to 100 files per week across a team).
Using medical staff credentialing and provider payer enrollment techniques, workflows, and best practices.
Compliance with facility Bylaws, Rules and Regulations; Credentialing Policy and Procedures; and other applicable accreditation/payor standards (e.g. NCQA, TJC, DHS, DMHC, CMS, delegated credentialing agreements, etc.).

Responsibilities

Directly supervising 3 - 6 staff members responsible for using medical staff credentialing and provider payer enrollment techniques, workflows, and best practices.
Implementing credentialing and health plan payer enrollment function processes and monitoring assigned staff compliance.
Auditing files for completion, monitoring results, and gaining/sustaining stakeholder buy-in.
Initiating and cultivating partnerships with other members of the Centralized Processing team, department management, medical staff /hospital/health plan/payor leadership and information technology teams.
Ensuring compliance and optimal efficiency for appropriate membership for UCSF Medical Staff, Advanced Practice Professionals and CVO contracted facilities.
Responding to data integrity/system interface issues, primary source credentialing information, onboarding and revenue channel disruptions.
Performing auditing functions pursuant to facility Bylaws, Rules and Regulations; Credentialing Policy and Procedures; and other applicable accreditation/payor standards.
Involvement in the department’s engagement, educational, and professional development activities.
Facilitating team meetings, preparation of agendas and related materials for team huddles, medical staff meetings, and peer review activities.
Monitoring compliance with medical staff bylaws, provider enrollment requirements, rules, regulations, policies, and procedures.
Interpreting and developing policy and procedures.
Managing training and orientations to a variety of constituents to sustain best practices.