Director, Credentials Verification Office

Nemours Children's Health is seeking an experienced Certified Director of the Credentials Verification Office (CVO) to manage the operations of Enterprise credentialing functions. The director is responsible for overseeing the operational function and daily activities of the CVO and ensures compliance with all relevant regulations and standards.  This position provides best practice administrative management services for all aspects of the Department.  The position serves as a liaison between CVO, Medical Staff Services, practice leaders and other customers.

The ideal candidate must have Certification from the National Association Medical Staff Services as a Certified Professional In Medical Staff Services Management (CPMSM) or a Certified Provider Credentials Specialist (CPCS) 

The candidate must have a strong background in Medical Staff credentialing functions. 

The CVO supports two Medical Staffs of approximately 2400 physicians, nurse practitioners, physician assistants, and other practitioners at Nemour's Children's Health in Wilmington and Nemours Children's Health in Florida.

Essential Job Functions:

Plans, implements, organizes and directs a comprehensive, enterprise-wide credentialing verification program.

• Establishes, influences and implements policies, procedures and systems to accomplish the credentials verification and enrollment process.
• Directs all aspects of a credentialing verification system.
• Researches, selects controls and maintains credentialing software.
• Leads a comprehensive and technologically driven verification process to ensure continuity, accuracy, completeness and timeliness.
• Protects the integrity and security of the database.
• Provides guidance on accreditation, regulatory issues, national standards and best practices.

• Plans and manages the operations of CVO.

• Hires, trains, evaluates and develops staff.
• Establishes and monitors shares departmental metrics and key performance indicators.
• Establishes reliable methods, checklists and other work products to ensure consistency in performance and compliance with regulatory and accrediting agencies.
• Creates and monitors a departmental budget.
• Promotes ongoing education.

• Promotes and directs the use of process improvement tools and thinking to create greater value.

• Collaborates with key stakeholders on managing an ongoing reporting process that is accurate and timely.
• Focuses on creating and aligning goals in support of the organization's Mission.

Serves as liaison between CVO, Medical Staff Services, practice leaders and other customers.

• Manages requests for customized reports and other information.
• Provides guidance on accreditation, regulatory issues, national standards and best practices. 

Requirements: 

• Bachelor's Degree preferred– In lieu of the educational requirements, previous work history in credentialing and years of experience may be considered.

• Certification by the National Association Medical Staff Services as a Certified Professional In Medical Staff Services Management (CPMSM) or a Certified Provider Credentials Specialist (CPCS) is required

• MD Staff software experience is preferred.  

• Experience in Hospital credentialing and privileging is required. 

Experience:

• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certifications required. 
• A minimum of 10 years of experience in the Medical Staff Credentialing Services field, with at least 5 years in leadership. 

Skills

• Ability to maintain a high level of confidentiality.
• Ability to analyze and interpret complex data with the end goal of presenting and creating tactical plans. Organizes information and data to identify and explain trends, problems and their causes.
• Ability to organize work and create priorities.
• Excellent communication skills, both written and oral.
• Excellent interpersonal skills. Exhibits confidence and professional diplomacy while identifying, organizing, facilitating, and sustaining mutually-beneficial partnerships and alliances with people at all levels of the organization.
• Ability to gain cooperation and support, resolve differences, and reach compromises with others.
• Working knowledge and expertise in MDStaff.
• Knowledge of Joint Commission, NCQA, CMS, and other regulatory standards

Nemours Children's Health is an internationally recognized children's health system. With more than 1.7 million patient encounters annually, we provide medical care in five states through two freestanding state-of-the-art children's hospitals — Nemours Children's Hospital, Delaware and Nemours Children's Hospital, Florida. Our pediatric network includes 80 primary-urgent-and specialty care practices and more than 40 hospitalists serving 19 affiliated hospitals. We generate annual revenues of more than $1.7 billion derived from patient services, contributions from the Alfred I. DuPont Trust, as well as other income.

As one of the nation's premier pediatric health systems, we're on a journey to discover better ways of approaching children's health. Putting as much focus on prevention as cures and working hand in hand with the community to make every child's world a place to thrive. It's a journey that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention, leading to the healthiest generations of children ever.

Inclusion and belonging guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build an inclusive and supportive environment. All of our associates are expected to ensure that these philosophies are embedded in their day-to-day work with colleagues, patients and families.

To learn more about Nemours Children's and how we go well beyond medicine, visit us