Mid-Columbia Medical Center
Manager, Centralized Verification Organization
Mid-Columbia Medical Center, California, Missouri, United States, 65018
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.Job Requirements:Education and Work Experience:Bachelor’s Degree in business, information management, health administration or related field or equivalent combination of education/related experience: RequiredMaster's Degree: PreferredFive years' relevant experience: PreferredOne year's leadership experience: PreferredLicenses/Certifications:NAMSS Certified Provider Credentialing Specialist (CPCS): RequiredNAMSS Certified Professional Medical Services Management (CPMSM): Required within 2 years of employmentEssential Functions: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.Organizational Requirements:Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
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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.Job Requirements:Education and Work Experience:Bachelor’s Degree in business, information management, health administration or related field or equivalent combination of education/related experience: RequiredMaster's Degree: PreferredFive years' relevant experience: PreferredOne year's leadership experience: PreferredLicenses/Certifications:NAMSS Certified Provider Credentialing Specialist (CPCS): RequiredNAMSS Certified Professional Medical Services Management (CPMSM): Required within 2 years of employmentEssential Functions: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.Organizational Requirements:Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
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