Every day, almost 20,000 Hartford HealthCare employees come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network.
The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.
Provides Strategic leadership to the HHC System Credentialing Verification Organization (CVO). Oversees the departmental operations, assuring the delivery of superior credentialing verification services for all hospital entities, their medical staffs, and any contracted clients. Provides oversight for provider enrollment functions for all HHC employed providers, and assures timely enrollment of all HHC facilities with payers.
Leadership and Management
Coaches and mentors staff, utilizing H3W leadership behaviors
Identifies roles and responsibilities within the CVO and documents job descriptions
Recommends Staffing levels
Collaborates and partners with medical staff offices, medical staff leadership and executive leadership
Contributes discretionary effort to strategic initiatives and priorities
Researches tools and solutions to support and optimize the CVO
Develops and ensures metrics, goals, and projects are documented, executed, tracked, and accomplished
Represents the CVO, makes presentations to, and interacts with internal and external customers
Directs the supervision of personnel, which includes work allocation, training, 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
Maintains a thorough and working knowledge of important industry standards set forth by organizations such as the Joint Commission, NCQA, CMS, etc.
Develops policies, procedures and standard work for the CVO in accordance with standards, rules, regulations and medical staff bylaws
Provides continuous feedback to Executive Staff as it relates to observed issues with staff, customer concerns, volume of work
Leads and participates in LEAN daily management huddles
Monitors key metrics that drive performance
Establishes targets and thresholds for performance
Engages staff in improving performance through idea generation, participation in A3 projects
Documents standard s work for all important business processes
Shares customer feedback and uses that feedback to establish value added business processes
Medical Staff Credentialing
Oversees team of medical staff credentialing specialists
Provides primary source verification and credentialing practices in compliance with standards, regulations and medical staff bylaws
Provides orientation, education and training of staff regarding business practices, standards, regulations
Creates and monitors standard work for medical staff credentialing practices
Establishes standards for turnaround time and monitors performance relative those those standards
Oversees a team of provider enrollment specialists
Provides orientation, education and training g of staff regarding business practices, standards and regulations
Creates and monitors standard work for provider enrollment practices
Benchmarks with national professional organizations and other CVOs to determine best practices for provider enrollment
Establishes standards for turnaround time and monitors performance relative to hose standards.
Assures the timely enrollment of facilities with payers.
Oversees the data integrity and functionality of credentialing and enrollment databases.
Oversees the Master Provider Database
Optimizes the functionality of these database
Responsible for ensuring that the credentialing data is accurate and available for other systems to utilize as their source
Assures appropriate interface with other IT systems
Establishes procedures for report generation
Finance and Budget
Evaluates key financial, budgetary and other metrics related to operations
Monitors financial results related to provider enrollment
Proposes budget, monitors compliance for the department.
Provides information forecasts, trends or other conditions that may affect operations or budget planning
Participates in the development of FTE budgetary expenses, operational expenses and capital budgets.
Collaboration and Partnership with Internal Stakeholders
Serves on system committees as requested
Provides consultation and expertise on credentialing practices to other departments
Interacts with local clients to determine customer requirements and satisfaction
Reports To: Vice President of Safety and Quality
# Workers Responsible For: 1 Direct Reports, 21 In-Direct Reports
Nature of Supervision: Direct Supervision for 1 Manager CVO. All other staff report through the Manager.
Interacts with all members of the CVO, HHCMG, ICP and local medical staff offices.
Interacts with members of the local medical staff, medical staff leadership, administration, and departmental representatives.
Interacts with providers during the application process
Interacts with regulatory and certifying agencies
Interacts with other healthcare facilities
Interacts with payers
Education: Bachelor’s degree in Science or health care related field is required. Master’s degree in health care related field or equivalent is preferred.
Experience: At least 5 years’ experience in Medical Staff Services with management experience. At least 5 years’ experience in Medical Staff Services with management experience at a CVO is preferred.
Licensure, Certification, Registration: CPCS Certification is required. CPMSM (Certified professional Medical Staff Management) from NAMSS certification is preferred.
Knowledge, Skills and Ability Requirements:
Understanding of the credentialing and privileging processes for hospitals and ambulatory care settings
Computer Proficiency, Microsoft Office to include Word, Excel, Power Point
Ability to work with multiple application specific databases
Advanced knowledge of medical terminology
Excellent interpersonal skills and customer service orientation
Ability to work within and promote a team environment
Attention to detail
Ability to work with multiple projects and deadlines and to support medical staff leaders and functions.
Strong analytical skills
Expert knowledge of JC and NCQA standards, as well as federal and state regulations with regard to medical staff credentialing
Ability to coach and mentor staff
Excellent written and verbal communication skills and organizational ability
Possesses strong management skills.
Experience with database management
Foundational experience in quality improvement approaches such as LEAN.
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.
Internal Number: 18155853
About Hartford HealthCare
Our fully integrated health system includes a tertiary-care teaching hospital, an acute-care community teaching hospital, an acute-care hospital and trauma center, three community hospitals, the state’s most extensive behavioral health network, a large multispecialty physician group, a regional home care system, an array of senior care services, a large physical therapy and rehabilitation network and an accountable care organization. Through its institute model, Hartford HealthCare offers the highest standards of care for cancer, heart and vascular services, neuroscience, orthopedics and urology.