Provider Enrollment Supervisor

Job no: 494974
Position type: Staff - Full-Time
Location: Health Science Campus Hospital
Division/Equivalent: University Medical Center
School/Unit: Medical Dir Office - 108930
Categories: Healthcare Positions, Hospital Administration, Full-Time, None

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Title: Provider Enrollment Supervisor

Department Org: Medical Dir Office - 108930

Employee Classification: J1 - Salaried Full Time HSC

Bargaining Unit: Bargaining Unit Exempt

Primary Location: Health Science Campus Hospital

Shift:  1

Start Time:  7:00a  

End Time:  3:30p

Posted Salary: Salary based on experience and education

Float: False

Rotate: False

On Call: False

Travel: False

Weekend/Holiday: False

Job Description:

Under the direction of the Director of the Central Verification Office, provides supervision and evaluation of assigned CVO staff for the enrollment of all University of Toledo Physicians, LLC providers for the UTP, LLC delegated carriers and other plans applicable. Assures credentialing services meet all NCQA, State, and Federal requirements for timeliness and quality. interpret and ensures compliance with CVO policies and procedures and all credentialing-related duties for the University of Toledo Medical Center, the UTP, LLC providers, and UTP, LLC delegated carriers.

The Provider Enrollment Supervisor position is eligible for flexible work arrangements that balance the operational demands of the department with the preferred work arrangements of staff. Examples of a flexible work arrangement may include a hybrid and/or remote work option, compressed work week schedule, or flexible hours.

Minimum Qualifications:

1. Bachelor's degree or equivalent training in Business Administration or Management required.
2. Three years of direct credentialing and primary source verification experience.
3. Five years of provider enrollment or enrollment management experience.
4. Knowledge of Microsoft Access, Word, and Excel necessary.
5. Extensive working knowledge of NCQA standards. Participation in past NCQA accreditation surveys preferred.
6. Knowledge of primary source verification, State and Federal credentialing standards and requirements including ongoing monitoring and reporting responsibilities.
7. NAMSS certification preferred (CPMSM/CPCS). If not currently certified, the successful candidate must be eligible to obtain NAMSS certification within two years of being hired.

8. Experience and working knowledge of CAQH online database.
9. Experience with PECOS and other government payor online enrollment systems preferred.

Communication and Other Skills:
1. Excellent written and verbal communication skills required.
2. Ability to prepare reports.
3. Ability to follow direction or act on own initiative, as required.
4. Must be extremely detail-oriented and well organized.
5. Must demonstrate experience in quality improvement, personal empowerment, diversity, and teamwork.

Conditions of Employment:

All UToledo employees on all campuses, including those working on campus and working remotely, are required to be fully vaccinated against Covid-19, or have an approved exemption.
To promote the highest levels of health and well-being, the University of Toledo campuses are tobacco-free.  To further this effort, the University of Toledo Health Science Campus Medical Center is requiring candidates for employment to be nicotine-free.  Pre-employment health screening requirements will include cotinine (nicotine) testing, as well as drug and other required health screenings for the position. With the exception of positions within University of Toledo Main Campus and the University of Toledo College of Medicine and Life Sciences, the employment offer is conditional upon successful completion of a cotinine test and Occupational Health clearance.


Equal Employment Opportunity Statement:

The University of Toledo is an equal opportunity, affirmative action employer. The University of Toledo does not discriminate in employment, educational programs, or activities on the basis of race, color, religion, sex, age, ancestry, national origin, sexual orientation, gender identity and expression, military or veteran status, disability, familial status, or political affiliation. 

The University is dedicated to the goal of building a culturally diverse and pluralistic faculty and staff committed to teaching and working in a multicultural environment and strongly encourages applications from women, minorities, individuals with disabilities, dual-career professionals and covered veterans.

The University of Toledo provides reasonable accommodation to individuals with disabilities. If you require accommodation to complete this application, or for testing or interviewing, please contact the Human Resources Department at 419-530-4747 between the hours of 8:30AM and 5:00PM or apply online for an accommodation request. 

Computer access is available at most public libraries and at the Office of Human Resources located in the Center for Administrative Support on the Main Campus of the University of Toledo.

Advertised: Eastern Daylight Time
Application close:

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