As the Supervisor Credentialing at Virtua Health, you'll oversee the VMG Credentialing Coordinators and Specialists to ensure compliance with CAQH and other regulatory requirements. You'll manage the enrollment process for Durable Medical Equipment, foster relationships across various departments, and ensure that new clinicians meet onboarding requirements. You'll not only guide your team through daily operations but also play a crucial role in staff training and development, ensuring the highest quality service is delivered to the community.

To qualify for the Supervisor Credentialing role at Virtua Health, candidates should have at least 5 years of experience in billing and credentialing, alongside a minimum of 5 years in a supervisory position. An associate's degree is required, while a bachelor's degree is preferred. Additionally, candidates should have exemplary communication and organizational skills, as well as the ability to manage changing priorities effectively.

Virtua Health enforces compliance in the credentialing process primarily through diligent supervision of the VMG Credentialing team, ensuring accurate and active clinician information in compliance with CAQH, PECOS, and other relevant guidelines. The Supervisor Credentialing will implement processes that uphold organizational standards and regulations, ensuring all staff are trained effectively to maintain compliance with payer audits and current regulations.

The Supervisor Credentialing position at Virtua Health is a full-time role primarily operating on the first shift. This allows for consistent collaboration with various departments, ensuring effective communication and management of daily credentialing processes, which typically aligns with regular business hours to facilitate accessibility for clinicians and other stakeholders.

Success as a Supervisor Credentialing at Virtua Health hinges on excellent communication skills, both verbal and written, as well as advanced organizational skills to manage changing priorities efficiently. Moreover, a deep understanding of regulatory compliance, a proactive attitude, and the ability to foster team engagement and development are crucial for leading your team effectively and ensuring optimal service delivery.

In answering this question, it's important to share your hands-on experiences with CAQH and PECOS. Discuss specific compliance initiatives you led or were a part of, detailing how you ensured accuracy and regulatory adherence. Mention the outcomes of your efforts and any challenges you faced, emphasizing your problem-solving skills.

Your response should highlight your leadership style. Discuss how you set clear expectations, provide ongoing training, and foster an environment where team members feel valued. Illustrate with examples of how you've motivated your team to achieve compliance targets and maintain high quality by implementing regular check-ins and performance measurements.

When discussing strategies for process improvement, articulate specific methodologies such as Lean or Six Sigma. Provide examples of past improvements you've driven that increased efficiency or accuracy. Explain how you would engage your team in suggesting enhancements and how you would measure the effectiveness of these strategies over time.

Prepare a scenario that demonstrates your conflict resolution skills. Outline the issue, your approach to resolving it, and the positive outcome. Show how you balanced empathy with adherence to company policies and how the resolution led to improved team dynamics.

Discuss your approach to training, including the development of orientation programs and ongoing training opportunities. Highlight your commitment to mentoring new hires and providing them with resources that will facilitate their acclimatization to the credentialing processes.

Your response should emphasize the importance of data integrity in maintaining compliance and facilitating smooth operations. Discuss how you monitor and preserve data accuracy and the steps you take to correct discrepancies, ensuring that the information reflects real-time status for clinicians.

Outline a systematic approach for addressing non-compliance, which could include direct communication with the clinician, discussing the importance of compliance for their practice and patient safety, and collaborating to create a plan that facilitates resolution within regulatory timelines.

In your response, highlight how you’ve worked with various teams such as billing or medical affairs in prior positions. Provide examples of collaborative projects and how effective communication among teams led to improved outcomes, emphasizing your role as a connector between departments.

This is a chance to showcase your knowledge of DME compliance guidelines. Discuss your past roles that involved DME and the critical compliance measures necessary for successful billing and credentialing in that area, providing insights into how you ensure adherence to recognized guidelines.

Detail your strategies for keeping abreast of the latest regulations, such as attending workshops, subscribing to relevant newsletters, or being active in professional networks. Emphasize how this proactive approach has allowed you to implement necessary changes in past roles effectively.