Jillian Davis has been called “kind, smart, and simply brilliant.” These three traits are nothing to be ashamed of. On the contrary, anyone should be proud to be thought of in such ways. They are not mere words. Jillian’s abilities and drive support any description of her character. She searches for results, and she undeniably gets them. She has indeed earned every bit of praise from her colleagues. Her rewards extend past compliments.
Fifth Avenue Healthcare Services is pleased to announce the recent promotion of CVO Director of Operations Jillian Davis, CPCS, to Executive Director of Credentialing Operations. Jillian Davis’ career at Fifth Avenue Healthcare Services continues to flourish as she continually seeks to improve credentialing processes.
Jillian Davis is a Certified Provider Credentialing Specialist (CPCS) through the National Association of Medical Staff Services. CPCS certification proves a person’s competence in the skills needed for provider credentialing.
Credentialing is one of the most pivotal actions that healthcare practices and organizations can perform before they hire providers. Determining if a provider has a legitimate license and the proper training to treat patients is a lengthy process. Additionally, credentialing specialists are expected to check work and criminal histories. Providers with malpractice claims against them could be denied employment, health plan enrollment, and insurance. Providers who are found to have valid licenses and training, as well as clean records, can be eligible for jobs, enrollment in many health plans, and malpractice insurance.
Becoming a certified provider credentialing specialist (CPCS) is a testament to exceptional proficiency in the tasks related to credentialing. CPCSs have shown without a doubt that they can follow accreditation regulations. They can also create and implement processes that adhere to compliance protocols. They can be trusted to review provider applications and relevant documents and discreetly manage sensitive information. The best CPCSs should have abundant communication and organizational skills.
Confirming all of a provider’s credentials may sound easy to outsiders, but to those in the industry, the job demands more than following instructions. Each step must be performed to accepted standards. Every detail must be examined. Overlooked items can result in unqualified providers being allowed to administer care to patients.
Being meticulous has unquestionably helped Jillian Davis excel in her field. Her in-depth knowledge of the NCQA (National Committee for Quality Assurance), URAC (Utilization Review Accreditation Commission), AAAHC (Accreditation Association for Ambulatory Health Care), CMS (Centers for Medicare & Medicaid Services), and other federal regulations enabled her to continue on a path of professional growth and success. Nearly a decade of diligence and perseverance helped her hone her skills into what they are today. Under Jillian’s leadership, she guided Fifth Avenue Healthcare Services and owned entities, Primoris Credentialing Network and 5ACVO, to obtain NCQA Credentialing Accreditation.
Jillian Davis: The Beginning
Jillian Davis’ career began when she became a Client Service Coordinator for Meridian Business Centers. She soon transitioned into a Center Manager role. She effortlessly performed various administrative duties that laid the foundation for what would come. Auditing bills to locate discrepancies before sending them to the accounting department helped her polish her attention to detail, an ability no credentialing expert can forgo. Jillian was also responsible for initiating and revising procedures. This was just one more task that imparted knowledge she would take to subsequent jobs.
Jillian Davis: More Experience
In 2014, Jillian Davis accepted the role of Credentialing Coordinator at CenseoHealth (now SignifyHealth). This company contracts with healthcare providers who make in-home visits for seniors to evaluate their health for Medicare Advantage plans. She performed the essential duties of a credentialing specialist, like acquiring the provider’s relevant documentation and ensuring that all applications were accurately completed. She verified the provider’s requirements for work approval when dealing with specific states and health plans.
Jillian also established and maintained a system that managed the timely processing of credentialing that observed NCQA standards. These guidelines render a framework for organizations to apply the best practices to accurately and efficiently credential healthcare professionals. They ultimately serve to protect patients from inferior treatment.
Jillian was eventually promoted to Credentialing Manager, where her list of tasks and accomplishments grew. She developed workflow processes that scaled with increased business demands. This involved conducting frequent audits that identified objectives and error rates. Jillian used this data to help the credentialing department target and eliminate their weaknesses and maintain a higher efficiency level.
Jillian Davis + More Triumphs!
From there, Jillian accepted a new challenge. She joined Blue Cross Blue Shield Texas as a Credentialing Delegation Oversight Coordinator. For 90+ years, Blue Cross Blue Shield Texas has been the largest health insurer in its state. They have served notable companies like American Airlines, Halliburton, the Texas A&M system, and Texas Instruments. A company that strives to be the most experienced insurer in the state and country usually will not hire people who cannot keep up their service philosophy. They want talented and trustworthy experts who can do their jobs without fail.
Jillian’s duties included conducting annual audits of credentialing policies and files of entities granted delegated credentialing functions on behalf of Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas. She collaborated with a Network Management team to review and improve delegation agreements. In addition, she developed auditing tools and department training manuals to enhance her company’s credentialing team’s skills.
In 2018, Jillian Davis obtained her CPCS (Certified Provider Credentialing Specialist) certification. Accomplishing this solidified her expert knowledge in credentialing and bolstered her professional reputation. This achievement helped raise her potential to advance in the industry, which she soon did.
Jillian joined Tenet Physician Resources in 2018. As their National Credentialing Manager, Jillian was a national liaison between her company, operations markets, and health plans to resolve any issues and concerns. She maintained tight credentialing time-frames with health care practices and health plans, ensuring new physician onboards got added to Tenet National contracts by their start date. To facilitate this, Jillian created procedures to update and manage practitioner files for enrollment purposes efficiently.
She also collaborated with the National Director of Credentialing to help define departmental processes and execute strategic initiatives. Her other responsibilities included conducting delegation oversight reviews and audits of contracted health plans and putting corrective action plans established by these health plans and internal departments into effect.
Her work at Tenet produced quantifiable results. In one year, she was able to accomplish credentialing delegation with 70% of contracted health plans.
Jillian Davis, 5ACVO and Fifth Avenue Healthcare Services
Jillian soon sought new horizons. Joining Fifth Avenue Healthcare Services, Jillian Davis’ professional career took her to another company where she could apply her extensive credentialing expertise. She joined as the Director of Credentialing and today is the Executive Director of Credentialing Operations for 5ACVO.
During her short tenure with the company, Jillian has increased efficiency, improved team synergies, and promoted better internal credentialing processes. Jillian’s leadership was critical to Fifth Avenue Healthcare Services, Primoris Credentialing Network, and 5ACVO obtaining NCQA Credentialing Accreditation. She continues to make a lasting, positive impact on the Fifth Avenue family and the clients we serve.
5ACVO, NCQA Credentialing Accredited, specializes in primary source verification for medical professionals to facilitate employment and health plan enrollment. 5ACVO is the credentialing brand of Fifth Avenue Healthcare Services. It prides itself on reducing the traditional 52 credentialing steps to 6. This grants providers and administrators lower costs and less work. 5ACVO is dedicated to making credentialing better and easier for everyone. Simpler credentialing affects how soon providers can start work, levels of patient care, and profit margins.
Jillian has used industry knowledge to help guarantee the credentialing operations and service team’s ongoing effectiveness and success. By applying the industry’s best practices to improve 5ACVO’s credentialing processes, Jillian has allowed her team to deliver the finest service possible.
Her unmatched tenacity to seek improvement has helped raise Fifth Avenue Healthcare Services’ excellent standards. As the new Executive Director of Credentialing Operations, Jillian Davis brings her ability to fine-tune even the sharpest system to maximum effectiveness. 5ACVO’s prestige is due to its speed and commitment to aligning with state requirements. The company has grown substantially, increasing its client base like never before.
Under Jillian’s watch, she helped the company complete the intricate auditing process to obtain NCQA credentialing accreditation, meaning the 5ACVO team has proven it can give its providers an elevated level of quality service. Beginning the billing process as soon as possible can expedite and increase revenue. Providers can rely on 5ACVO to get to work sooner than if they performed conventional credentialing. This win boosts 5ACVO and Fifth Avenue Healthcare Services’ reputations as industry leaders.
“Jillian has very quickly become indispensable to every aspect of our credentialing program. After making changes in our CVO and leading us through the NCQA accreditation process, she began retooling our procedures in health plan enrollment. In her new role, she will not only make all the parts of the process more excellent but also make them work together more seamlessly.”
Joe Spann, CEO of Fifth Avenue Healthcare Services
Jillian’s promotion to Executive Director of Credentialing Operations recognizes her vital skills in a field with no room for errors. She is expected to excel in her new role as she has done many times before.
The Future
One look at her professional achievements will tell you that Jillian Davis seeks to improve any situation wherever she finds herself. Whether it be company policies and procedures or workflows that need improvement, Jillian will use every opportunity that comes her way to enhance any work environment.
Even if a process does not seem problematic at first glance, Jillian can still streamline it so that her colleagues can do their jobs more efficiently and accurately. It has been said that she is a breath of fresh air to everyone she meets. With her inclination for innovation and stellar history, this is not difficult to believe.
More information about Fifth Avenue Healthcare Services
Fifth Avenue Healthcare Services is a NCQA Credentialing Accredited family of healthcare companies. Sister companies include 5ACVO (credentialing and primary source verification specialists), Fifth Avenue Agency (MPLI and medical malpractice insurance specialists), and Primoris Credentialing Network (credentialing and provider enrollment specialists with 54+ health plan and network provider enrollment options).
This article was initially published by Fifth Avenue Healthcare Services here. For more information on Fifth Avenue Healthcare Services, please visit FifthAvenueHealthcareService.com or Contact Us.
