Manager, Centralized Verification Organization - Onsite at Adventist Health

Roseville, California, United States -

Full Time

Start Date

Immediate

Expiry Date

03 Jun, 26

Salary

155590.0

Posted On

05 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing Operations Management, Workflow Design, Work Allocation, Training, Internal Procedures Enforcement, Problem Resolution, Performance Evaluation, Personnel Actions, Productivity Motivation, Subject Matter Expert, Process Streamlining, Turnaround Time Management, Operational Metrics Reporting, NCQA Certification Maintenance, Regulatory Knowledge, Policy Development

Industry

Hospitals and Health Care

Description

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: Required * Master's Degree: Preferred * Five years' relevant experience: Preferred * One year's leadership experience: Preferred Licenses/Certifications: * NAMSS Certified Provider Credentialing Specialist (CPCS): Required * NAMSS Certified Professional Medical Services Management (CPMSM): Required within 2 years of employment Essential 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 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. Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

Responsibilities

This role manages the Centralized Verification Organization's (CVO) credentialing operations, overseeing workflow design, work allocation, training, and enforcement of internal procedures. The manager acts as a subject matter expert focused on streamlined processes, monitoring turnaround times, and ensuring high-quality delivery of credentialing products.