Essentia Health
Central Verification Organization and Enrollment Manager
Essentia Health, Duluth, Minnesota, United States, 55806
Central Verification Organization and Enrollment Manager
This range is provided by Essentia Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range $76,315.00/yr - $114,483.00/yr
Job Description This leader is responsible for the oversight of the Central Verification Organization (CVO) and enrollment team, working under limited supervision and reporting to the leader of Medical Staff Services. This position manages all aspects of provider and facility enrollment with commercial payors, Medicare, and Medicaid, and ensures ongoing compliance with federal, state, and accreditation requirements. The Manager also oversees the medical staff credentialing process – including initial and recredentialing, expirables management, delegated credentialing agreements, and primary source verification. This role requires a results‑driven leader who can guide day‑to‑day operations, ensure data integrity, improve process efficiency, and lead a high‑performing team.
Key Responsibilities
Lead and manage the overall operations of the CVO and provider enrollment
Develop, implement, and enforce standard work and internal controls to ensure compliance, process efficiency, and quality outcomes
Oversee day‑to‑day activities, including application processing, primary source verification, and recredentialing
Monitor key performance indicators and analyze credentialing/enrollment reports to identify trends and opportunities for process improvement
Ensure compliance with accrediting bodies and regulatory agencies (e.g., NCQA, CMS, The Joint Commission)
Ensure the accuracy and integrity of credentialing data in the credentialing database; collaborate with system analysts and department leadership to support system optimization
Serve as the CVO and enrollment subject matter expert and liaison for organizational senior level leadership (e.g., revenue cycle, clinical operations) in support strategic planning and operational efforts
Manage and monitor delegated credentialing agreements to ensure compliance operational excellence.
Lead departmental meetings and drive effective communication across teams
Hire, train, supervise, and evaluate credentialing and enrollment staff; provide coaching, performance feedback, and professional development
Education Requirements
Bachelors degree in healthcare administration or related field, or Certified as a Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist certified
Required Qualifications
Minimum of 3 years’ experience in Credentialing and/or Provider Enrollment
Proven ability to lead and develop teams in a high‑volume, compliance driven environment
Preferred Qualifications
Working knowledge of medical staff/provider credentialing concepts and comprehensive knowledge of state, and federal regulatory requirements and accreditation standards preferred
Certified Professional Credentialing Specialist - CPCS
Certified Provider Enrollment Specialist - CPES
Employee Benefits at Essentia Health At Essentia Health, we’re committed to supporting your well‑being, growth, and work‑life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.
Job Location 520 Building - Duluth
Shift Rotation Day Rotation (United States of America)
Shift Start/End days/days
Hours Per Pay Period 80
Compensation Range $76315 - $114483 / year
Union FTE 1
Weekends Call Obligations Seniority level Mid‑Senior level
Employment type Full‑time
Job function Education and Training
Industries Hospitals and Health Care
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Base pay range $76,315.00/yr - $114,483.00/yr
Job Description This leader is responsible for the oversight of the Central Verification Organization (CVO) and enrollment team, working under limited supervision and reporting to the leader of Medical Staff Services. This position manages all aspects of provider and facility enrollment with commercial payors, Medicare, and Medicaid, and ensures ongoing compliance with federal, state, and accreditation requirements. The Manager also oversees the medical staff credentialing process – including initial and recredentialing, expirables management, delegated credentialing agreements, and primary source verification. This role requires a results‑driven leader who can guide day‑to‑day operations, ensure data integrity, improve process efficiency, and lead a high‑performing team.
Key Responsibilities
Lead and manage the overall operations of the CVO and provider enrollment
Develop, implement, and enforce standard work and internal controls to ensure compliance, process efficiency, and quality outcomes
Oversee day‑to‑day activities, including application processing, primary source verification, and recredentialing
Monitor key performance indicators and analyze credentialing/enrollment reports to identify trends and opportunities for process improvement
Ensure compliance with accrediting bodies and regulatory agencies (e.g., NCQA, CMS, The Joint Commission)
Ensure the accuracy and integrity of credentialing data in the credentialing database; collaborate with system analysts and department leadership to support system optimization
Serve as the CVO and enrollment subject matter expert and liaison for organizational senior level leadership (e.g., revenue cycle, clinical operations) in support strategic planning and operational efforts
Manage and monitor delegated credentialing agreements to ensure compliance operational excellence.
Lead departmental meetings and drive effective communication across teams
Hire, train, supervise, and evaluate credentialing and enrollment staff; provide coaching, performance feedback, and professional development
Education Requirements
Bachelors degree in healthcare administration or related field, or Certified as a Credentialing Specialist (CPCS) or Certified Provider Enrollment Specialist certified
Required Qualifications
Minimum of 3 years’ experience in Credentialing and/or Provider Enrollment
Proven ability to lead and develop teams in a high‑volume, compliance driven environment
Preferred Qualifications
Working knowledge of medical staff/provider credentialing concepts and comprehensive knowledge of state, and federal regulatory requirements and accreditation standards preferred
Certified Professional Credentialing Specialist - CPCS
Certified Provider Enrollment Specialist - CPES
Employee Benefits at Essentia Health At Essentia Health, we’re committed to supporting your well‑being, growth, and work‑life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.
Job Location 520 Building - Duluth
Shift Rotation Day Rotation (United States of America)
Shift Start/End days/days
Hours Per Pay Period 80
Compensation Range $76315 - $114483 / year
Union FTE 1
Weekends Call Obligations Seniority level Mid‑Senior level
Employment type Full‑time
Job function Education and Training
Industries Hospitals and Health Care
Referrals increase your chances of interviewing at Essentia Health by 2x
Get notified about new Admissions Manager jobs in Duluth, MN.
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr