Provider Enrollment Supervisor – req3319 – Flexible Work eligible

Employment Type: Staff - Regular

Employee Class: Salaried Full Time HSC

Bargaining Unit: BU Exempt

Shift: 1

Work Hours: 7:00 am - 3:30 pm

Hours Per Week: 40

FTE: 1

Location: Generic Location

Department: Medical Dir Office

Number of Openings: 1

Salary Range: Salary is commensurate of education and/or experience

Grade: Salaried HSC - J105

Float: N/A

Rotate: N/A

On Call: N/A

Travel: N/A

Weekend/Holiday: N/A

Requisition ID: req3319

Position Control Number (PCN): H94139

Posting Period: open until filled

To promote the highest levels of health and well-being, theUniversity of Toledo campuses are tobacco-free.  To further this effort, the University of Toledo Health Science Campus MedicalCenter is requiring candidates for employment to be nicotine-free.  Pre-employment health screening requirementswill include cotinine (nicotine) testing, as well as drug and other requiredhealth screenings for the position. The employment offer is conditional uponsuccessful completion of a cotinine test and Occupational Health clearance.Position Description:

Underthe direction of the Director of the Central Verification Office, providessupervision and evaluation of assigned CVO staff for the enrollment of all Universityof Toledo Physicians, LLC providers for the UTP, LLC delegated carriers andother plans applicable. Assures credentialing services meet all NCQA, State,and Federal requirements for timeliness and quality. interpret and ensures compliancewith CVO policies and procedures and all credentialing-related duties for theUniversity of Toledo Medical Center, the UTP, LLC providers, and UTP, LLCdelegated carriers.

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

Qualifications:

Qualifications/Knowledge/Skills/Abilities:
1.  Bachelor's degree or equivalent training in BusinessAdministration 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 NCQAaccreditation surveys preferred.
6.  Knowledge of primary source verification, State and Federal credentialingstandards and requirements including ongoing monitoring and reportingresponsibilities.
7.  NAMSS certification preferred (CPMSM/CPCS). If not currently certified, thesuccessful candidate must be eligible to obtain NAMSS certification withintwo years of being hired.

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

Working Conditions:Works in a professional office environment with possible high stress levels.

The above list of duties is intended to describe the general nature and level of work performed by people assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the people so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct and control the work of employees under his/her supervision.

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 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, or at the satellite HR Office located at the Facilities Services Building, Suite 1000 on the Health Science Campus.