Manager of Credentialing, Quality & Comp
Salary: Commensurate with Experience
Title: Manager of Credentialing, Quality & Compliance
Category: Management and Professional
Department: Student Health Services
Date Posted: 07/09/2015
8AM - 5PM
Under the general direction of the Director of Student Health Services (SHS) and the Director of Counseling and Psychology Services (CAPS) the Manager of Credentialing, Quality, and Compliance is responsible for the effective management and direction of three critical healthcare support operations: credentialing, quality improvement, and compliance. The incumbent will ensure all policies, procedures, and related documentation are current, accurate, and sufficient to meet operational and accreditation standards.
Implement, plan and coordinate Quality Management studies on an ongoing basis for Student Health Services (SHS) and Counseling and Psychological Services (CAPS). Continuously monitor and evaluate findings and make recommendations for improvements to two department Directors and the Assistant Vice Chancellor for Health and Wellness. Perform data collection, supervise data input, and create reports that assist in defining opportunities for the operational improvement and future planning through comparative analytics, using various modeling and statistical analysis tools. Responsible for directing and coordinating the peer review and utilization review process for both departments' licensed independent practitioners. Establish protocols and standards, assist with training and implementing of changes, and ensure such changes are fully implemented and working properly. Monitor and review the annual accreditation processes. Direct, oversee, and coordinate a highly effective and efficient credentialing, re-credentialing, and privileging process for the appropriate SHS and CAPS employees, ensure compliance to University of California Office of the President credentialing and privileging protocols. Operate and comply with all regulatory reporting requirements. Ensure that all SHS and CAPS processes are in accord with HIPAA, FERPA and CMIA regulations and that all employees are fully educated as to their roles.
Bachelors Degree required. Bachelors Degree in a healthcare or related field is desired. 3-5 years of experience in Quality Assurance, Quality Management, Quality Improvement (QA/QM/QI), risk management and/or utilization review in a healthcare setting.
Knowledge of HIPAA (medical privacy), FERPA (privacy of educational records) and CMIA (confidentiality of medical information) standards and experience applying those standards to the workplace. Experience with Accreditation Association for Ambulatory Health Care (AAAHC) accreditation standards. The Joint Commission or other healthcare accreditation agency required.
Experience supervising staff, especially those in a bargaining unit.
Knowledge of healthcare functions and operations Knowledge of Accreditation Association for Ambulatory Health Care (AAAHC), The Joint Commission, International Association of Counseling Services (IACS), American Psychological Association (APA and other accreditation standards for physical and mental healthcare organizations.
Knowledge of credentialing and privileging requirements for patient care providers.
Knowledge of healthcare quality assurance principles and evaluation methodologies.
Excellent written language skills ability to read, analyze, and interpret common technical reports and legal documents. Ability to write and edit policies and procedures, issue memoranda, and compile programmatic reports.
Excellent mathematical skills ability to work mathematical concepts and perform statistical computations
Ability to present information to large and small audiences, and communicate effectively orally in and in writing to all levels of staff. Ability to effectively manage different responsibilities, multiple tasks and varied timelines simultaneously and positively interact with all SHC and CAPS colleagues and campus and community partners.
Knowledge of state and federal regulations related to privacy and confidentiality of health information.
Ability to evaluate, analyze, and implement changes. Knowledge and skill in use of computer technology. Strong analytical and reasoning skills able to identify, analyze and define problems, and proactively recommend solutions related to quality improvement activities.
Experience with EM diagnostic coding and ICD coding. Registered Health Information Administrator or Registered Health Information Technician is preferred.
Experience in higher education or medical field.
Demonstrated expert knowledge and skill in use of computer technology.
In the Heart of Inland Southern California, UC Riverside is located on nearly 1,200 acres near Box Springs Mountain in Southern California; the park-like campus provides convenient access to the vibrant and growing Inland region. The campus is a living laboratory for the exploration of issues critical to growing communities' air, water, energy, transportation, politics, the arts, history and culture. UCR gives every student the resources to explore, engage, imagine and excel.
At UC Riverside we celebrate diversity and are proud of our #12 ranking among the nation for most diverse universities (US News and World Report 2013-2014). Become part of a place that fosters success for all its constituents, students, faculty, and staff, and where work/life balance and campus culture are integral to our way of life.
UCR is ranked 55th among top public universities (US News and World Report 2013-2014).
The University of California is an Equal Opportunity/Affirmative Action Employer with a strong institutional commitment to the achievement of excellence and diversity among its faculty and staff. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other characteristic protected by law.
For information about our generous employee benefits package, visit: Employee Benefits Overview(http://atyourservice.ucop.edu/employees/new_employee/orientation.html)
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Position Type: Employee
University of California, Riverside
900 University Ave.