Senior Credentialing Operations Leader

CVS Health; United States; On-site; USD 83,000 - 183,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Retirement Savings

Wellness Programs

Job summary

CVS Health is seeking a Senior Manager, Credentialing Operations to lead the Credentialing Verification Organization, ensuring accuracy, integrity and compliance of provider credentialing data across lines of business, delivering timely credentialing decisions to support member access to care.

You will drive operational excellence, data-driven insights, and continuous process improvement, partnering with Network Management, Provider Relations, Provider Services, and Health Delivery teams to

Qualifications

• 5+ years in provider data management or credentialing.
• 3+ years leading and developing teams.
• Experience in credentialing operations.
• Knowledge of Medicare, Medicaid, and/or Commercial lines.
• Strong analytical and decision-making skills.
• Ability to influence stakeholders and drive results.
• Strong written and verbal communication.

Responsibilities

• Leads a unit delivering credentialing services.
• Sets strategic direction for Credentialing Operations.
• Analyzes performance metrics against objectives.
• Implements strategies to boost quality, compliance, service.
• Advises internal and external stakeholders.
• Leads audits and corrective actions.
• Partners across networks to improve outcomes.
• Drives continuous improvement and accountability.

Skills

Credentialing ops

Leadership

Data analysis

Stakeholder influence

Regulatory knowledge

Education

Bachelor's degree

Job description

CVS Health is seeking a Senior Manager, Credentialing Operations to lead the Credentialing Verification Organization, ensuring accuracy, integrity and compliance of provider credentialing data across lines of business, delivering timely credentialing decisions to support member access to care.

You will drive operational excellence, data-driven insights, and continuous process improvement, partnering with Network Management, Provider Relations, Provider Services, and Health Delivery teams to