Director, Credentialing Operations — AI-Driven Process Leader

Hispanic Alliance for Career Enhancement; Olympia (WA); On-site; USD 100,000 - 232,000; Full time

Job summary

CVS Health is seeking a Lead Director, Credentialing Operations to oversee the Credentialing Verification Organization (CVO) and ensure high-quality credentialing services across multiple lines of business. You will manage a large team, coordinate on-shore/off-shore vendor support, and drive process improvements in a highly regulated environment.

Responsibilities include directing operational management for Commercial, Medicare, and Medicaid credentialing, ensuring data accuracy, and aligning

Qualifications

• 7+ years directly related experience in Healthcare Operations with a production focus.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Advance working knowledge of business systems, applications, and tools supporting credentialing, provider data and inventory management.
• Proven ability to work collaboratively at all levels.
• Ability to effect change.
• Exercises sound judgment and demonstrates analytical/data-driven decision-making skills.

Responsibilities

• Oversee operational management of Commercial, Medicare, Medicaid credentialing operations.
• Manage a team of ~100 employees through multiple managers.
• Oversee on-shore and off-shore vendor support tied to business operations to align resources and monitor partner performance.
• Contribute to planning and administration of company programs and initiatives supporting Credentialing Operations.
• Accountable for department initiatives and objectives with stakeholders and leadership.
• Implement organizational policies and goals based on best practices in the field.
• Build and develop a strong operations management team through coaching and mentorship.
• Cultivate and manage relationships with internal business partners.
• Ensure Credentialing policies align with accreditation and regulatory bodies.
• Administer audit procedures for data accuracy and compliance.

Skills

Healthcare operations

Leadership

Data-driven decisions

Change management

Cross-functional collaboration

Analytical skills

Education

Bachelor's degree or equivalent

Tools

Credentialing software

Job description

CVS Health is seeking a Lead Director, Credentialing Operations to oversee the Credentialing Verification Organization (CVO) and ensure high-quality credentialing services across multiple lines of business. You will manage a large team, coordinate on-shore/off-shore vendor support, and drive process improvements in a highly regulated environment.

Responsibilities include directing operational management for Commercial, Medicare, and Medicaid credentialing, ensuring data accuracy, and aligning