Responsibilities:

• Authenticate time-sensitive information, interpret principles and standards and compile reports, ensuring that Joint Commission (JC), National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS) compliance rules and deadlines are met
• Prepare critical information for the consideration of Hospital Advisory Committee (HAC) members, via ballots and meetings to grant and reaffirm privileges for UIHC practitioners; prepare documentation for CEO review and approval; and send final information to appropriate parties
• Prepare/review credentialing data and conduct ballots and meetings for managed care approval and re-approvals
• Review privileging and credentialing data and reports to develop improvements for CSO policies and procedures
• Review accuracy rates in data entry, trend errors and resolve concerns and questions to provide oversight and analysis that enhances CSO performance
• Advise faculty, staff and leadership on credentialing and privileges processes
• Manage the CSO SharePoint site, posting documents and granting site access
• Conduct reviews for the Iowa Insurance Commissioner to certify entities as reviewers of insurance claim denials for the State of Iowa
• Member of Iowa Credentialing Coalition (ICC) which is responsible for the Universal Application used throughout the state; oversee revisions to the application

Why my job matters:

Credentialing and privileging is more complex than it appears!  Accuracy of practitioner data and timely reports are an integral part of the smooth operations of the CSO.  Errors or delays would impinge patient care, quality and safety, and UIHC revenues.  I continually strive to go above and beyond protocol to ensure that the CSO is meeting or exceeding JC, NCQA, CMS and other industry standards.

Education/Background:

• Bachelor of Arts in Economics & Business – Cornell College, May/1987; Cum Laude

I started at the University of Iowa in 1987 as a Clerk II in the Admissions Office. In 1988, I moved to the Business Office at UIHC as a Clerk III and worked with Blue Cross/Blue Shield and Delta Dental Insurances. I transferred to the CSO in 1999, was promoted to a Clerk IV within the year and am now the Manager of Systems and Quality Control.

Special Interests & Activities:

• Exceptional Performance Award 2013
• Heart & Hands Award 2008
• Above & Beyond Award 2007
• Crochet baby hats and chemo hats for UIHC
• Enjoy Zumba and Les Mills Body Combat, card playing and collect miniature decks of cards, Isabel Bloom statues and Noah’s Ark memorabilia

Contact:

Phone: 319-384-9291
Fax: 319-384-9293
jacqueline-buol@uiowa.edu

When asked, “What inspires you?”

“Knowing that the Clinical Staff Office thoroughly scrutinizes each practitioner before they obtain privileges to touch and see patients at UIHC, so they will provide the best care for each patient they encounter.  That is what motivates me in the CSO.”