Manager, Central Verification Office

at NorthShore University Health System in Skokie, Illinois, United States

Job Description

Manager, Central Verification Office

Position Highlights:
Position: Manager, Central Verification Office
Location: Skokie, IL
Full Time
Hours: Monday-Friday, 8:30am - 5pm
Required Travel: N/A

Job Summary:
Frontline management of staff and operations of the Endeavor Health Central Verification Office (CVO). Develops, educates, manages, and monitors the processes and procedures that support credentialing, enrollment, credentialing, expiable data, database integrity and delegated credentialing processes. Oversees all the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accreditation and regulatory agencies. Daily management of the credentialing staff, assigns work, monitors deadlines, applications, and turnaround times.

What you will do:
Manages the CVO credentialing processes for all Endeavor Health System clinical providers, in accordance with the TJC, CMS, NCQA, DNV, state and federal laws and system policies.
Manages the credentialing database and associated modules, ensuring accuracy of data, and reporting to downstream systems. Monitors critical data for extensive analysis and report generation.
Monitors and reports turnaround times for processing of credentials applications, with focus on delivery of a high-quality product with greatest efficiency, in the least amount of time.
Prepares for and coordinates credentialing audits in compliance with managed care delegated contract requirements and NCQA audit compliance.
Oversees the supervision of personnel, which includes 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.
Represents the CVO to internal and external customers. Problem solves and manages issues as they arise.

What you will need:
Education: Bachelor's Degree
Certification: National Association of Medical Staff Services Certification (NAMSS) in:
Certified Provider Medical Services Management (CPMSM) and/or
Certified Provider Credentials Specialist (CPCS)
Certification is required within three years of hire. Maintenance of Certification is required.

Experience: 7 years of experience in Credentialing in addition to prior management experience.
Unique or Preferred Skills:
Ability to make administrative/procedural decisions and judgements.
Ability to investigate and analyze information and draw conclusions.
Ability to process computer data, format and generate reports.
Ability to develop, supervise and train employees, including organizing, prioritizing, and scheduling work assignments.
Ability to communicate effectively, both orally and in writing.
Ability to foster a cooperative working environment.
Ability to manage in a team environment.
Ability to multitask, manage multiple priories, customers, and deadlines.
Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
Skill in developing policy and procedure documentation and training tools.
Knowledge of related accreditation and regulatory certification requirements.
Knowledge of medical credentialing, provider privileging and standards.
Knowledge of Bylaws, policies and regulations of Endeavor hospitals and legal environment in which they operate.

Benefits:
Career Pathways to Promote Professional Growth and Development
Various Medical, Dental, Pet and Vision options
Tuition Reimbursement
Free Parking
Wellness Program Savings Plan
Health Savings Account Options
Retirement Options with Company Match
Paid Time Off and Holiday Pay
Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org.

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to "help... For full info follow application link.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.