UCSD Layoff from Career Appointment: Apply by 09/19/2017 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor. Eligible Disability Counseling and Consulting services (DCC) or Special Selection clients should contact their Vocational Rehabilitation Counselor for assistance.
This position will remain open until filled.
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.
Bachelors' degree with emphasis in finance, accounting, business management or healthcare administration (or equivalent combination of education & experience).
Five plus (5+) years' experience coordinating provider enrollment and credentialing activities in a medical group.
Certification through NAMSS as Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional in Medical Services Management (CPMSM).
Demonstrated proficiency with MS Office Products (Excel, Word & PowerPoint).
Effective analytical skills with the ability to assess and identify potential risks associated with the provider enrollment process.
Demonstrated ability to use independent judgement and manage confidential information.
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.
Master's Degree in Finance or Accounting or a related field.
Seven plus (7+) years' experience coordinating provider enrollment and credentialing activities in a large, multi-specialty medical group.
Three plus (3+) 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.
UC San Diego is an academic powerhouse and economic engine, recognized as one of the top 8 public universities by U.S. News and World Report. Innovation is central to who we are and what we do. Here, students learn that knowledge isn't just acquired in the classroom - life is their laboratory. UC San Diego's rich academic portfolio includes six undergraduate colleges, five academic divisions and ...five graduate and professional schools. The university's award-winning scholars are experts at the forefront of their fields with an impressive track record for achieving scientific, medical and technological breakthroughs.