CVO Manager
at Adventist Health System

Date Posted: 3/16/2017

Job Description



Job:  Other Non-Clinical Professional

Organization:  Adventist Health System Corporate Office

Shift:  Day

Job Posting:  Mar 15, 2017, 7:46:21 AM

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

We are currently seeking qualified candidates for a CVO Manager position that will be based in our Managed Care department. This position is based in Altamonte Springs, FL.

Under limited supervision, oversees the operations of the Adventist Health System (AHS) Centralized Verification Office (CVO) to develop, manage and monitor processes and procedures that support the credentialing, re-credentialing, expirables data management, and delegated credentialing contract processes. Oversees all of the credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies. Supervises credentialing staff in the day-to-day management of the overall CVO credentialing process and database management.

Specific job duties include:
 
  • Manages the CVO credentialing process for all AHS clinical providers, in accordance with NCQA and CMS accreditation standards, Federal and State laws, and AHS policies.
  • Coordinates the management the credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems. Monitors critical data for extensive analysis and report generation.
  • Coordinates the management of the electronic credentials application, to ensure distribution, receipt, processing, and timely delivery to health system entity.
  • Coordinates the management of the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
  • Monitors and reports turnaround times for processing of credentials applications, with continued focus on delivery of a high quality product, with the greatest efficiency, in the least amount of time.
  • Monitors the currency of AHS entity-specific medical staff bylaws, rules and regulations, and policies and procedures, ensuring compliance with accrediting organization requirements; participates in development and review of CVO Operating policies and procedures, Managed Care Delegated Credentialing policies and procedures; develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to current operating environment.
  • Provides on-site consultations across AHS and its affiliates with regards to credentialing practices and services; prepares and conducts credentialing orientations and provides updates as appropriate on new policies and procedures.
  • Analyzes NCQA and CMS standards and develops criteria to ensure compliance; revises general aspects of credentialing and privileging process as necessary; makes recommendations for and implements changes in policies and procedures.
  • Prepares for and coordinates credentialing audits in compliance with the managed care delegated credentialing contracts.
  • Functions as primary CVO credentials contact for all internal and external inquiries; develops and maintains positive working relationships.
  • 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 as appropriate; makes presentations to and interacts with various internal and external customers on issues pertinent to area of specialty.
  • Performs miscellaneous job-related duties as assigned.

Job Requirements

Education Requirements:
 
  • Bachelor’s Degree in business, healthcare administration or related field
  • NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) or actively pursuing certification and secure within 1 year of hire.
 
Experience Requirements:
 
  • Five years managerial experience with two years in a CVO or provider-enrollment department

If this position sounds like a great match for your skills set and experience, please apply online now!


Job Snapshot

About Us

About Adventist Health System

Who We Are

We are one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.

Who You Are

You are a compassionate, talented professional who wants to work in an environment where you can live out your faith and your values. You are excited about being part of a team that uses the latest technology and medical research to ensure patients receive quality care, but who also recognize that great care is always personal. You enjoy going out of your way to make each patient and their family feel special, and are passionate about guiding them toward optimal health.

Our Community

Our community is global and so is our reach. From coordinating medical mission trips in Ethiopia to planting school gardens in Florida, we are constantly seeking ways to go beyond hospital walls in improving the health of our communities. As a member of our team, you will be encouraged to use your talents in fun, meaningful ways that bring joy and healing to people around the world.

Our Mission

Part of this worldwide network, Adventist Health System was founded in 1973 to support and strengthen the Seventh-day Adventist health care organizations in the Southern and Southwestern regions of the United States. Today it is a national leader in quality, safety and patient satisfaction, comprised of 46 hospital campuses and nearly 77,000 employees.

Although separated by geography, each of our facilities is united by the mission of Extending the Healing Ministry of Christ. Today we continue the tradition of whole-person care by practicing and sharing CREATION Health, a blueprint for living a healthy, happy life based on the principles given in the Bible’s creation story: Choice, Rest, Environment, Activity, Trust, Interpersonal relationships, Outlook and Nutrition.

We provide comprehensive benefits, training and advancement opportunities. We care for our employees as well as we care for our patients.