System Director, Credentialing Verification Organization

DescriptionSummary: The System Director, Credentialing Verification Organization (CVO) is responsible for ensuring physicians, clinicians, and other providers are credentialed, appointed and privileged with health plans, hospital medical staff’s, other patient care facilities, physician organizations and other network arrangements such as a clinical integrated network (“CIN”) and accountable care organization (“ACO”). Through numerous entry points throughout the system, this position is responsible for establishing and then leading/managing the standards, governance, process-flows, resource allocation and IT system access to the system credentialing software tool. Additionally, this position is accountable for maintaining up-to-date data for each physician, clinician, and provider in the database and online system, including data and reports used for payer roster management. This includes initial credentialing and re-credentialing as required by regulatory bodies, either every two years, three years, or other date spans as required. Demographic data is to be gathered and stored in a standardized manner, including proof of timely renewal of licenses and certifications. This position is accountable, on behalf of CHRISTUS Health, for meeting and maintaining needed accreditation standards including NCQA, The Joint Commission and URAC as required by contractual and regulatory requirements. This position will also be accountable to start and manage a Credentialing Verification Organization (“CVO”) for CHRISTUS Health, allowing delegated arrangements to be put into place on behalf of employed physicians, CIN, ACO, PHO, and all networks for CHRISTUS Health.  Education: Bachelor’s Degree; equivalent experience may be considered in lieu of Bachelor’s Degree. Experience: Minimum 10 years of experience in credentialing and payer roster management.Extensive knowledge and experience in hospital medical staff and managed care credentialing, including delegate credentialing.Minimum 5 years of experience in management / direct supervision of staff.Expert in MD Staff credentialing software Skills: Excellent communication skillsComputer skills including significant knowledge of Word, Excel, and PowerPointWorking knowledge of industry requirements for NCQA, URAC, and The Joint Commission. Licenses, Registrations or Certifications: CPCS – NAMSS (Certified Provider Credentialing Specialist from National Association of Medical Staff Services), preferredCPMSM – NAMMS (Certified Professional Services Management from the National Association of Medical Staff Services), preferred EEO is the law - click below for more information:  https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at (844) 257-6925. Additional Information: - Specialty: Billing and Insurance Specialist - Location: 5101 North O Connor BoulevardIrving, Texas 75039 - Contact: About the Company: CHRISTUS Health is an international Catholic, faith-based, not-for-profit health system comprised of more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. Sponsored by the Sisters of Charity of the Incarnate Word in Houston and San Antonio and the Sisters of the Holy Family of Nazareth, the mission of CHRISTUS Health is to extend the healing ministry of Jesus Christ. To support our healthcare ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on staff who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States. EXTENDING THE HEALING MINISTRY OF JESUS CHRIST We are inspired by our mission, vision and core values to deliver compassionate, high quality health care, improving the health of the communities we serve. Above all, we are committed to providing our customers and their family members with a truly unique healing experience, one that embodies our values and respects the dignity and worth of each person. Creating a health care system that is truly excellent in all areas is an ongoing effort.