Manager, Central Verification Office
Edward-Elmhurst Health
- Skokie, IL
- Permanent
- Full-time
- Position: Manager, Central Verification Office
- Location: Skokie, IL
- Full Time
- Hours: Monday-Friday, 8:30am – 5pm
- Required Travel: N/A
- 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.
- 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.
- 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