Senior Manager, Credentialing Operations — Lead Quality & Growth

CVS Health; Hartford (CT); Hybrid; USD 83,000 - 183,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus and equity programs

Paid time off

Job summary

CVS Health is seeking a Senior Manager, Credentialing Operations to lead our Credentialing Verification Organization. You will oversee credentialing services, monitoring quality, and driving process improvements to ensure timely, accurate credentialing decisions across health plans and networks.

In this senior role, you will collaborate with cross-functional teams, manage audits, and guide strategic initiatives that enhance provider experiences and ensure regulatory compliance.

Qualifications

• Bachelor's degree or equivalent work experience.
• 5+ years in provider data management, credentialing, or related healthcare ops.
• Experience leading teams (3+ years).
• Knowledge of Medicare, Medicaid, and/or Commercial lines of business.

Responsibilities

• Lead Credentialing Operations to deliver accurate credentialing services.
• Set strategic direction and align processes with enterprise goals.
• Analyze performance metrics to identify improvements.
• Drive quality, compliance, and service delivery enhancements.
• Act as trusted advisor to stakeholders on credentialing initiatives.
• Lead audit activities and remediation planning.

Skills

Provider data management

Provider network operations

Credentialing

Healthcare operations

Education

Bachelor's degree or equivalent

Job description

CVS Health is seeking a Senior Manager, Credentialing Operations to lead our Credentialing Verification Organization. You will oversee credentialing services, monitoring quality, and driving process improvements to ensure timely, accurate credentialing decisions across health plans and networks.

In this senior role, you will collaborate with cross-functional teams, manage audits, and guide strategic initiatives that enhance provider experiences and ensure regulatory compliance.