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Under limited supervision by the Director of UVA Health Centralized Verification Office (CVO), oversees the operations of the UVA Health Centralized Verification Office (CVO) to develop, manage and monitor processes and procedures that support the provider onboarding, credentialing, re-credentialing, expirables data management, delegated credentialing and proxy credentialing 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.

• Manages the CVO credentialing process for all UVA Health System clinical and Advanced Practice providers, in accordance with TJC, NCQA, URAC, and CMS Medical Staff accreditation standards, Federal and State laws, and University 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 UVA Health System 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 UVA Health entities with regards to credentialing practices and services; prepares and conducts credentialing orientations and provides updates as appropriate on new policies and procedures.

• Analyzes TJC, NCQA, URAC, 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 UPG/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 in collaboration with Director, 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.

• In addition to the above job responsibilities, other duties may be assigned.

Position Compensation Range: $63,939.20 - $102,294.40 Annual

Education: High school graduate or equivalent required. Bachelor’s Degree Preferred.

Experience: 5 years relevant experience required.

Licensure: CPCS or CPMSM certification preferred.

The University of Virginia, i ncluding the UVA Health System which represents the UVA Medical Center, Schools of Medicine and Nursing, UVA Physician’s Group and the Claude Moore Health Sciences Library, are fundamentally committed to the diversity of our faculty and staff. We believe diversity is excellence expressing itself through every person's perspectives and lived experiences. We are equal opportunity and affirmative action employers. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran status, and family medical or genetic information.