UCSD Layoff from Career Appointment: Apply by 01/15/2019 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 01/25/2019. Eligible Special Selection clients should contact their Disability Counselor for assistance.
The Manager of Provider Enrollment reports to the Assistant Director of Operations Support and is responsible for planning, coordinating and managing the daily activities of the team responsible for the accurate and timely enrollment of UCSD providers with both governmental and commercial payers for purposes of claims submission.
The Manager must have a thorough understanding of the entire revenue cycle process and will serve as the Clinical Practice Organization's representative between providers, hospital departments, contracting, marketing, medical staff administration and the health plans.
A Bachelor's Degree in business, healthcare administration or related area; and/or equivalent experience/training.
Five (5+) or more years of relevant experience coordinating provider enrollment and credentialing activities in a medical group.
Proven customer service skills and ability to effectively supervise and prioritize activities of subordinate staff, and to manage complex workflow and multiple priorities involved with billing and/or collections operations.
Strong proficiency with MS Office Products (Excel, Word and PowerPoint).
Effective analytical skills with ability to assess and identify potential risks associated with the provider enrollment process.
Demonstrated ability to use independent judgement and manage confidential information.
Certification through NAMSS as Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional in Medical Services Management (CPMSM).
Clear communication skills, both oral and written, to be able to effectively manage a team and to work with staff, faculty and outside organizations.
Comprehensive and thorough understanding of all elements of provider enrollment in federal programs and delegated credentialing necessary to support these processes with both governmental and commercial payers.
Understanding of revenue cycle processes including how provider enrollment impacts revenue.
Six Sigma or other LEAN Management Training.
A Master's Degree in Finance or Accounting or a related field.
Seven (7+) plus years experience coordinating provider enrollment and credentialing activities in a large, multi-specialty medical group.
Three (3+) plus years experience in a management role.
Experience conducting and managing payer credentialing audits according to industry standard guidelines such as NCQS, TJC, CMS, DMHC, DHCS and state requirements and regulations.
Experience with Epic, MS Access, MS Visio, Morrisey and/or other credentialing applications.
Must be able to work various hours and locations based on business needs.
Employment is subject to a criminal background check and pre-employment physical.
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