Credentialing Specialist - Hybrid/Remote, NCQA Focus

CVS Health; Farmers Branch (TX); Hybrid; USD 23,000 - 39,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Bonus eligible

Job summary

CVS Health is seeking a Credentialing Specialist in Farmers Branch, TX. The role supports clinicians through the Signify Health credentialing process, handling applications, verifications, and database updates. Hybrid work arrangement is available, with onsite presence required at least monthly.

The position requires 1–3 years in credentialing, NCQA knowledge, and strong communication skills to coordinate with internal and external stakeholders. Comprehensive benefits apply to full‑time staff.

Qualifications

• 1-3 years of credentialing experience.
• Proficient with Google Suites.
• Familiar with NCQA accreditation standards.
• Excellent listening and communication skills.
• Ability to build relationships with internal and external stakeholders.

Responsibilities

• Review and process credentialing and re-credentialing files.
• Maintain a system for timely credentialing per NCQA policies.
• Query organizations and evaluate responses for NCQA compliance.
• Maintain current state licenses, DEA certificates, malpractice coverage, and other credentialing documents.
• Review background checks, drug tests, and TB screenings and record results.
• Assemble verified information for Credentialing Committee presentations.
• Verify providers' requirements for work in specific states and plans.
• Assist with ongoing monitoring of contracted clinicians.
• Utilize the MD Staff credentialing database to generate reports.
• Provide administrative support to department leadership and stakeholders.
• Maintain PHI privacy and security during work activities.

Skills

Active listening

Interpersonal skills

Stakeholder relations

Education

High school diploma or equivalent

Tools

Google Suites

Job description

CVS Health is seeking a Credentialing Specialist in Farmers Branch, TX. The role supports clinicians through the Signify Health credentialing process, handling applications, verifications, and database updates. Hybrid work arrangement is available, with onsite presence required at least monthly.

The position requires 1–3 years in credentialing, NCQA knowledge, and strong communication skills to coordinate with internal and external stakeholders. Comprehensive benefits apply to full‑time staff.