Director, Credentials Verification Office

The Director leads the Credentials Verification Organization (CVO) for UVA Health and its affiliated entities. The Director oversees the systems, processes, and staff responsible for primary source verification, credentialing support services, and provider onboarding functions related to credentialing and privileging.

The Director manages department operations and ensures credentialing activities are accurate, timely, and compliant with regulatory and accreditation requirements. The role includes developing systems and workflows that support organizational priorities and strengthen coordination across UVA Health.

This position partners closely with Medical Staff Offices, Revenue Cycle, and operational teams to support provider onboarding, credentialing verification, and managed care credentialing functions across the health system. The Director also supports the continued development of centralized credentialing services to promote consistency, efficiency, and strong coordination across UVA Health.

Essential Responsibilities

I. PROGRAM MANAGEMENT

A. Plans, implements, organizes, and directs the credentialing verification program

· Establishes andmaintainsan effective credentialing verification system.

· Directs the daily operations of the credentialing verification process.

· Evaluates and manages credentialing software and related technology.

· Ensurescredentialing files areaccurate, complete, and processedin a timely manner.

· Maintains the integrity and security of credentialing databases and records.

· Oversees credentialing-related provider onboarding processes to supporttimelyprovider onboarding across UVA Health entities.

B. Oversees operational performance and reporting

· Establishes performance expectations and productivity metrics for credentialing specialists.

· Tracks productivity, workflow, and volume indicators to support operational planning.

· Implements quality review processes to ensure credentialing files meet established standards before release to Medical Staff Offices for privileging review.

· Usesoperational data toidentifyimprovement opportunities and strengthen processes.

C.Maintainsoperating documents and records

· Ensures credentialing policies, procedures, and documentation remain current and compliant.

· Overseesdocument retention and record management practices to ensure the security of permanent records.

D. Plans and manages departmental activities

· Responsible forappropriate staffinglevels and team structure.

· Develops and implements departmental goals and operational priorities.

· Reviews workflows andidentifiesopportunities to improve efficiency and service.

· Manages departmental resources and budgets asappropriate.

E. Manages meeting and communication processes

· Supports meetings related to credentialing operations, including agenda development, documentation, and follow-up.

· Provides guidance on regulatoryrequirements, accreditation standards, and credentialing practices.

F. CVO and Client Collaboration

· Serves as a liaison between CVO staff and internal stakeholders.

· Works closely with Medical Staff Offices to support theprivilegingprocess.

· Performs credentialing activities in support of managed care sub-delegation arrangements, working in collaboration with Revenue Cycle teams responsible for provider enrollment and delegatedcredentialing oversight.

· Coordinates with IT and other departments on credentialing system integration andreporting needs.

· Maintains strong working relationships with system software administrators and operational partners responsible for provider data platforms (e.g.,Kyruus, Epic, Workday, Oracle, data warehouse systems) to address provider access issues and ensureaccuratecredentialing and privileging data across the health system.

· Responds to requests for customized reports,additionalverifications, or other credentialing services.

II. REGULATORY & QUALITY COMPLIANCE

· Ensures credentialing practicescomply withregulatory agencies and accreditation standards.

· Monitors regulatory updates and incorporates changes into policies and procedures as needed.

· Provides education to staffregardingregulatory and accreditation requirements.

· Participates in internalaudits, accreditation reviews, and regulatory surveys.

· Addresses audit findings andsupportscorrective actions when necessary.

III. LEADERSHIP

· Recruits, trains, mentors, and evaluates credentialing staff.

· Promotes professional development and ongoing education within the team.

· Establishes a positive work environment that supports collaboration and accountability.

· Identifiesopportunities toestablishteam leader roles within credentialing groups to support operational oversight and staff development.

· Supports career development pathways within the CVO to encourage growth and retention.

MINIMUM REQUIREMENTS:

Education

Bachelor’s Degree or 4 years of equivalent experience.

Licensure / Certification

NAMSS certification preferred:

· Certified Professional Medical Services Management (CPMSM)

· Certified Provider Credentialing Specialist (CPCS)

Experience

· Minimum of five (5) years of experience in credentialing, medical staff services, or related healthcare operations.

· At least two (2) years of management or supervisory experience preferred.

· Experience working in a health system, academic medical center, or multi-entity healthcare organization preferred.

Special Skills, Knowledge, and Abilities

· Demonstrated leadership and management ability.

· Knowledge of credentialing processes and verification practices.

· Experience with credentialing software andfamiliarity withrelatedprovider data platforms(e.g.,Credential Stream,Kyruus, Epic, Workday)

· Familiarity with regulatory and accreditation standards.

· Strong organizational and analytical skills.

· Attention to detail and ability to manage multiple priorities.

· Effective written and verbal communication skills.

· Ability to work collaboratively with clinical and administrative stakeholders.

PHYSICAL DEMANDS:

Job requires standing for prolonged periods, frequently bending/stooping, reaching (overhead, extensive, repetitive) and repetitive motion: computer keyboard. Proficient communicative, auditory and visual skills; Attention to detail and ability to write legibly; Ability to lift/push/pull less than 20lbs. May be exposed to chemicals.

The starting base rate for this role is $118,144.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

• Paid Time Off, Long-term and Short-term Disability, Retirement Savings

• Health Saving Plans, and Flexible Spending Accounts

• Certification and education support

• Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report “Best Hospitals” guide rates UVA Health University Medical Center as “High Performing” in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children’s is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA’s commitment to non-discrimination and equal opportunity employment.