University of California Irvine

Credentialing and Compliance Manager


Updated: Dec 17, 2021
Location: UC Irvine Campus
Job Type:
Department: Counseling Center


Job Opening ID: 28162Reports To: Administrative Supervisor 1Working Title: Credentialing and Compliance ManagerDepartment: Counseling CenterBargaining Unit: 99FLSA: Non-ExemptPayroll Job Code: 007376Job Location: UCI Campus- IrvinePercent of Time: 100%Work Schedule: 8-5 M-FEmployee Class: Career Position Summary: The Credentialing and Quality Manager works independently under the general supervision of the Quality Assurance Director/Assistant Director. The position is responsible for coordinating various aspects of the credentialing, re-credentialing and privileging processes for the Counseling Center clinical providers who provide client care. The Incumbent is responsible for analyzing and maintaining current data for each provider in a credential file and credentialing database in accordance with UCOP, UC Irvine, and appropriate accrediting agency protocols & guidelines, and is responsible for ensuring timely renewal of licenses and certifications. Under the general supervision of the Quality Assurance Director/Assistant Director. The incumbent provides analysis and investigation for agency requirements including audit cycles and record management. Coordinates audits of staff members' clinical and outreach activities. Investigates concerns arising from audit results. Reports findings to Quality Assurance Director/Assistant Director, and/or Outreach Director. The position provides high level administrative and analytical support to the Quality Assurance Director/Assistant Director. The incumbent is responsible for supporting the functions of the Quality Assurance Program, including tasks related to provider chart review, quality improvement, risk management, patient satisfaction, accreditation, and compliance. As needed, collects, tracks, and assists with departmental critical incident reports. Presents findings to Quality Assurance Director and/or other Leadership Team members. Ensures compliance with Counseling Center policies and procedures and State and Federal regulations through audits and investigations assigned by Management Team members. Follows up with staff training when appropriate. Ensures that all staff including volunteers, Peer Educators, COACHs, and LGBT Mentors are current with annual HIPAA training and other required UCLC trainings. In coordination with Leadership Team, identifies and addresses operational issues for the center. Provides suggestions to streamline, standardize, and improve clinic flow, front desk procedures, client and staff experience, and provides related staff training. Maintains knowledge of current accreditation requirements. Assists hiring committee in informing candidates of credentialing and privileging policies. Initiates and facilitates communication with candidates and assist with online applications; monitors application process to ensure timely completion. Under the direction of the Leadership Team, facilitates staff credentialing, re-credentialing, and privileging process for all new and current professional clinical staff in coordination with the designated Credentials Verification Organization (CVO). Conducts preliminary investigations, reviews data, and ensures compliance in preparation for review by the Credentialing Committee and the Governing Board in compliance with UCOP guidelines. Assist in the coordination of Clinical Chart Review as part of the Credentialing and Privileging Process as mandated by UCOP. Maintains credential files in accordance with UCOP, UC Irvine, and accrediting agency protocols and guidelines. The incumbent attends various clinical and administrative committees and meetings and assures follow-up, as needed. Completes trainings and attends meetings as requested. The incumbent is required to analyze large amounts of sensitive and confidential data. Performs EMR chart audits as part of quality management activities, including random monitoring of documentation compliance. Keeps abreast of current trends in job related field. Will act on behalf of the Quality Assurance Director in Quality Assurance Director's absence and may also represent the department at various meetings and committees as appropriate or designated. Back up coverage for front desk receptionist duties, including but not limited to: answering phones, scheduling clinical appointments, and checking-in clinical appointments. Scanning and filing of documents and mail as appropriate. Adheres to Counseling Center and University protocols, policies and procedures. Incumbent will also assist in projects or task as assigned. Compensation Range:Hourly Rate: $21.98 - $33.57 Department Website:https://counseling.uci.edu/Required:One (1) to three (3) years of related experience with BA/BS or equivalent combination of education and experience.Knowledge of Health Insurance Portability and Accountability Act (HIPAA), Federal Educational Rights and Privacy Act (FERPA), other federal and state laws relevant to mental health service provision and records, and American Psychological Association Ethical Principles for Psychologists and Code of Conduct.Working knowledge of State and Federal laws regarding release of health information.Demonstrated knowledge of all Microsoft applications, including Outlook, Excel, Word, Access, and PowerPoint. Must have excellent computer and software skills in order to complete ongoing projects, as assigned. Must be able to work in a busy environment with multiple interruptions and able to work in confined environment. Must possess strong customer service skills and ability to communicate clearly and tactfully with students, staff and other members of the public. Superior and effective interpersonal and communication skills. Ability to compose, edit, and proofread correspondence and reports. Ability to organize and prioritize workload to meet deadlines and to manage multiple priorities. Demonstrated ability to handle confidential matters/information with tact and discretion. Superior organization skills. Organizational skills to meet timelines established by law and department policy. Proven ability to maintain the strictest of confidence on sensitive issues using tact and diplomacy.Ability to anticipate and analyze problems and issues, determine appropriate solutions, and take action to mitigate potential negative effects as part of a team in order to meet the objectives of the counseling center.Ability to collaborate with the University Community consisting of Faculty, Staff, and Students and perform detailed tasks accurately with frequent interruptionsDemonstrated computer skills including word processing, spreadsheet, electronic mail, and calendar management. Strong written and verbal communication skills, ability to write, edit and proofread correspondence and other documents designed to communicate with a diverse constituency in a professional manner.Excellent organizational skills, demonstrated ability to prioritize workload, handle frequent interruptions, work independently, use initiative and follow through with complex tasks to meet deadlines.Ability to be flexible and supportive to other administrative positions.Demonstrated ability to follow complex verbal instructions.Demonstrated problem-solving skills, with the ability to quickly diagnose problems and develop multiple options for effective and timely resolution of issues and problems. Tolerance of ambiguity and ability to function well in a fast-paced environment with changing priorities and multiple stake holders.Experience working with electronic medical records. Desired: Master's degree in business, health administration, or similar field preferred.Working knowledge of medical and clinical terminology and ability to understand content of a health record sufficiently to perform review and data collection for quality management purposes. Minimum 2 years of experience managing provider credentialing in a health setting.Knowledge of current state, federal, and relevant accreditation requirements for credentialing of clinical staff. Experience with quality assuranceExperience with psychology credentialing and privileging process. Knowledge of processing National Practitioner Data Bank and Healthcare Integrity and Protection Data Bank for physician compliance.Knowledge of the current laws, procedures, and the American Psychological Association ethical principles that govern Required the practice of psychology in the State of California.Previous experience supporting a higher education Counseling Center. Working knowledge of the PALCard purchasing system or experience with similar systems.Experience with Point & Click scheduling software and databases.Experience with EPIC databaseKnowledge of University of California Policies and Procedures.Special Conditions Required:Work in confined area physically able to reach all filing areas. Final candidate subject to background check. As a federal contractor, UC Irvine is required to use E-Verify to confirm the work status of individuals assigned to perform substantial work under certain federal contracts/subcontracts.

The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact Human Resources at (949) 824-0500.

Job Opening ID: 28162Reports To: Administrative Supervisor 1Working Title: Credentialing and Compliance ManagerDepartment: Counseling CenterBargaining Unit: 99FLSA: Non-ExemptPayroll Job Code: 007376Job Location: UCI Campus- IrvinePercent of Time: 100%Work Schedule: 8-5 M-FEmployee Class: Career Position Summary: The Credentialing and Quality Manager works independently under the general supervision of the Quality Assurance Director/Assistant Director. The position is responsible for coordinating various aspects of the credentialing, re-credentialing and privileging processes for the Counseling Center clinical providers who provide client care. The Incumbent is responsible for analyzing and maintaining current data for each provider in a credential file and credentialing database in accordance with UCOP, UC Irvine, and appropriate accrediting agency protocols & guidelines, and is responsible for ensuring timely renewal of licenses and certifications. Under the general supervision of the Quality Assurance Director/Assistant Director. The incumbent provides analysis and investigation for agency requirements including audit cycles and record management. Coordinates audits of staff members' clinical and outreach activities. Investigates concerns arising from audit results. Reports findings to Quality Assurance Director/Assistant Director, and/or Outreach Director. The position provides high level administrative and analytical support to the Quality Assurance Director/Assistant Director. The incumbent is responsible for supporting the functions of the Quality Assurance Program, including tasks related to provider chart review, quality improvement, risk management, patient satisfaction, accreditation, and compliance. As needed, collects, tracks, and assists with departmental critical incident reports. Presents findings to Quality Assurance Director and/or other Leadership Team members. Ensures compliance with Counseling Center policies and procedures and State and Federal regulations through audits and investigations assigned by Management Team members. Follows up with staff training when appropriate. Ensures that all staff including volunteers, Peer Educators, COACHs, and LGBT Mentors are current with annual HIPAA training and other required UCLC trainings. In coordination with Leadership Team, identifies and addresses operational issues for the center. Provides suggestions to streamline, standardize, and improve clinic flow, front desk procedures, client and staff experience, and provides related staff training. Maintains knowledge of current accreditation requirements. Assists hiring committee in informing candidates of credentialing and privileging policies. Initiates and facilitates communication with candidates and assist with online applications; monitors application process to ensure timely completion. Under the direction of the Leadership Team, facilitates staff credentialing, re-credentialing, and privileging process for all new and current professional clinical staff in coordination with the designated Credentials Verification Organization (CVO). Conducts preliminary investigations, reviews data, and ensures compliance in preparation for review by the Credentialing Committee and the Governing Board in compliance with UCOP guidelines. Assist in the coordination of Clinical Chart Review as part of the Credentialing and Privileging Process as mandated by UCOP. Maintains credential files in accordance with UCOP, UC Irvine, and accrediting agency protocols and guidelines. The incumbent attends various clinical and administrative committees and meetings and assures follow-up, as needed. Completes trainings and attends meetings as requested. The incumbent is required to analyze large amounts of sensitive and confidential data. Performs EMR chart audits as part of quality management activities, including random monitoring of documentation compliance. Keeps abreast of current trends in job related field. Will act on behalf of the Quality Assurance Director in Quality Assurance Director's absence and may also represent the department at various meetings and committees as appropriate or designated. Back up coverage for front desk receptionist duties, including but not limited to: answering phones, scheduling clinical appointments, and checking-in clinical appointments. Scanning and filing of documents and mail as appropriate. Adheres to Counseling Center and University protocols, policies and procedures. Incumbent will also assist in projects or task as assigned. Compensation Range:Hourly Rate: $21.98 - $33.57 Department Website:https://counseling.uci.edu/Required:One (1) to three (3) years of related experience with BA/BS or equivalent combination of education and experience.Knowledge of Health Insurance Portability and Accountability Act (HIPAA), Federal Educational Rights and Privacy Act (FERPA), other federal and state laws relevant to mental health service provision and records, and American Psychological Association Ethical Principles for Psychologists and Code of Conduct.Working knowledge of State and Federal laws regarding release of health information.Demonstrated knowledge of all Microsoft applications, including Outlook, Excel, Word, Access, and PowerPoint. Must have excellent computer and software skills in order to complete ongoing projects, as assigned. Must be able to work in a busy environment with multiple interruptions and able to work in confined environment. Must possess strong customer service skills and ability to communicate clearly and tactfully with students, staff and other members of the public. Superior and effective interpersonal and communication skills. Ability to compose, edit, and proofread correspondence and reports. Ability to organize and prioritize workload to meet deadlines and to manage multiple priorities. Demonstrated ability to handle confidential matters/information with tact and discretion. Superior organization skills. Organizational skills to meet timelines established by law and department policy. Proven ability to maintain the strictest of confidence on sensitive issues using tact and diplomacy.Ability to anticipate and analyze problems and issues, determine appropriate solutions, and take action to mitigate potential negative effects as part of a team in order to meet the objectives of the counseling center.Ability to collaborate with the University Community consisting of Faculty, Staff, and Students and perform detailed tasks accurately with frequent interruptionsDemonstrated computer skills including word processing, spreadsheet, electronic mail, and calendar management. Strong written and verbal communication skills, ability to write, edit and proofread correspondence and other documents designed to communicate with a diverse constituency in a professional manner.Excellent organizational skills, demonstrated ability to prioritize workload, handle frequent interruptions, work independently, use initiative and follow through with complex tasks to meet deadlines.Ability to be flexible and supportive to other administrative positions.Demonstrated ability to follow complex verbal instructions.Demonstrated problem-solving skills, with the ability to quickly diagnose problems and develop multiple options for effective and timely resolution of issues and problems. Tolerance of ambiguity and ability to function well in a fast-paced environment with changing priorities and multiple stake holders.Experience working with electronic medical records. Desired: Master's degree in business, health administration, or similar field preferred.Working knowledge of medical and clinical terminology and ability to understand content of a health record sufficiently to perform review and data collection for quality management purposes. Minimum 2 years of experience managing provider credentialing in a health setting.Knowledge of current state, federal, and relevant accreditation requirements for credentialing of clinical staff. Experience with quality assuranceExperience with psychology credentialing and privileging process. Knowledge of processing National Practitioner Data Bank and Healthcare Integrity and Protection Data Bank for physician compliance.Knowledge of the current laws, procedures, and the American Psychological Association ethical principles that govern Required the practice of psychology in the State of California.Previous experience supporting a higher education Counseling Center. Working knowledge of the PALCard purchasing system or experience with similar systems.Experience with Point & Click scheduling software and databases.Experience with EPIC databaseKnowledge of University of California Policies and Procedures.Special Conditions Required:Work in confined area physically able to reach all filing areas. Final candidate subject to background check. As a federal contractor, UC Irvine is required to use E-Verify to confirm the work status of individuals assigned to perform substantial work under certain federal contracts/subcontracts.

The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact Human Resources at (949) 824-0500.

Job Opening ID: 28162Reports To: Administrative Supervisor 1Working Title: Credentialing and Compliance ManagerDepartment: Counseling CenterBargaining Unit: 99FLSA: Non-ExemptPayroll Job Code: 007376Job Location: UCI Campus- IrvinePercent of Time: 100%Work Schedule: 8-5 M-FEmployee Class: Career Position Summary: The Credentialing and Quality Manager works independently under the general supervision of the Quality Assurance Director/Assistant Director. The position is responsible for coordinating various aspects of the credentialing, re-credentialing and privileging processes for the Counseling Center clinical providers who provide client care. The Incumbent is responsible for analyzing and maintaining current data for each provider in a credential file and credentialing database in accordance with UCOP, UC Irvine, and appropriate accrediting agency protocols & guidelines, and is responsible for ensuring timely renewal of licenses and certifications. Under the general supervision of the Quality Assurance Director/Assistant Director. The incumbent provides analysis and investigation for agency requirements including audit cycles and record management. Coordinates audits of staff members' clinical and outreach activities. Investigates concerns arising from audit results. Reports findings to Quality Assurance Director/Assistant Director, and/or Outreach Director. The position provides high level administrative and analytical support to the Quality Assurance Director/Assistant Director. The incumbent is responsible for supporting the functions of the Quality Assurance Program, including tasks related to provider chart review, quality improvement, risk management, patient satisfaction, accreditation, and compliance. As needed, collects, tracks, and assists with departmental critical incident reports. Presents findings to Quality Assurance Director and/or other Leadership Team members. Ensures compliance with Counseling Center policies and procedures and State and Federal regulations through audits and investigations assigned by Management Team members. Follows up with staff training when appropriate. Ensures that all staff including volunteers, Peer Educators, COACHs, and LGBT Mentors are current with annual HIPAA training and other required UCLC trainings. In coordination with Leadership Team, identifies and addresses operational issues for the center. Provides suggestions to streamline, standardize, and improve clinic flow, front desk procedures, client and staff experience, and provides related staff training. Maintains knowledge of current accreditation requirements. Assists hiring committee in informing candidates of credentialing and privileging policies. Initiates and facilitates communication with candidates and assist with online applications; monitors application process to ensure timely completion. Under the direction of the Leadership Team, facilitates staff credentialing, re-credentialing, and privileging process for all new and current professional clinical staff in coordination with the designated Credentials Verification Organization (CVO). Conducts preliminary investigations, reviews data, and ensures compliance in preparation for review by the Credentialing Committee and the Governing Board in compliance with UCOP guidelines. Assist in the coordination of Clinical Chart Review as part of the Credentialing and Privileging Process as mandated by UCOP. Maintains credential files in accordance with UCOP, UC Irvine, and accrediting agency protocols and guidelines. The incumbent attends various clinical and administrative committees and meetings and assures follow-up, as needed. Completes trainings and attends meetings as requested. The incumbent is required to analyze large amounts of sensitive and confidential data. Performs EMR chart audits as part of quality management activities, including random monitoring of documentation compliance. Keeps abreast of current trends in job related field. Will act on behalf of the Quality Assurance Director in Quality Assurance Director's absence and may also represent the department at various meetings and committees as appropriate or designated. Back up coverage for front desk receptionist duties, including but not limited to: answering phones, scheduling clinical appointments, and checking-in clinical appointments. Scanning and filing of documents and mail as appropriate. Adheres to Counseling Center and University protocols, policies and procedures. Incumbent will also assist in projects or task as assigned. Compensation Range:Hourly Rate: $21.98 - $33.57 Department Website:https://counseling.uci.edu/Required:One (1) to three (3) years of related experience with BA/BS or equivalent combination of education and experience.Knowledge of Health Insurance Portability and Accountability Act (HIPAA), Federal Educational Rights and Privacy Act (FERPA), other federal and state laws relevant to mental health service provision and records, and American Psychological Association Ethical Principles for Psychologists and Code of Conduct.Working knowledge of State and Federal laws regarding release of health information.Demonstrated knowledge of all Microsoft applications, including Outlook, Excel, Word, Access, and PowerPoint. Must have excellent computer and software skills in order to complete ongoing projects, as assigned. Must be able to work in a busy environment with multiple interruptions and able to work in confined environment. Must possess strong customer service skills and ability to communicate clearly and tactfully with students, staff and other members of the public. Superior and effective interpersonal and communication skills. Ability to compose, edit, and proofread correspondence and reports. Ability to organize and prioritize workload to meet deadlines and to manage multiple priorities. Demonstrated ability to handle confidential matters/information with tact and discretion. Superior organization skills. Organizational skills to meet timelines established by law and department policy. Proven ability to maintain the strictest of confidence on sensitive issues using tact and diplomacy.Ability to anticipate and analyze problems and issues, determine appropriate solutions, and take action to mitigate potential negative effects as part of a team in order to meet the objectives of the counseling center.Ability to collaborate with the University Community consisting of Faculty, Staff, and Students and perform detailed tasks accurately with frequent interruptionsDemonstrated computer skills including word processing, spreadsheet, electronic mail, and calendar management. Strong written and verbal communication skills, ability to write, edit and proofread correspondence and other documents designed to communicate with a diverse constituency in a professional manner.Excellent organizational skills, demonstrated ability to prioritize workload, handle frequent interruptions, work independently, use initiative and follow through with complex tasks to meet deadlines.Ability to be flexible and supportive to other administrative positions.Demonstrated ability to follow complex verbal instructions.Demonstrated problem-solving skills, with the ability to quickly diagnose problems and develop multiple options for effective and timely resolution of issues and problems. Tolerance of ambiguity and ability to function well in a fast-paced environment with changing priorities and multiple stake holders.Experience working with electronic medical records. Desired: Master's degree in business, health administration, or similar field preferred.Working knowledge of medical and clinical terminology and ability to understand content of a health record sufficiently to perform review and data collection for quality management purposes. Minimum 2 years of experience managing provider credentialing in a health setting.Knowledge of current state, federal, and relevant accreditation requirements for credentialing of clinical staff. Experience with quality assuranceExperience with psychology credentialing and privileging process. Knowledge of processing National Practitioner Data Bank and Healthcare Integrity and Protection Data Bank for physician compliance.Knowledge of the current laws, procedures, and the American Psychological Association ethical principles that govern Required the practice of psychology in the State of California.Previous experience supporting a higher education Counseling Center. Working knowledge of the PALCard purchasing system or experience with similar systems.Experience with Point & Click scheduling software and databases.Experience with EPIC databaseKnowledge of University of California Policies and Procedures.Special Conditions Required:Work in confined area physically able to reach all filing areas. Final candidate subject to background check. As a federal contractor, UC Irvine is required to use E-Verify to confirm the work status of individuals assigned to perform substantial work under certain federal contracts/subcontracts.

The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.

UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact Human Resources at (949) 824-0500.

To apply, visit https://careersucirvine.ttcportals.com/jobs/8129690-credentialing-and-compliance-manager





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