At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

POSITION SUMMARY

Leads a business services unit that delivers credentialing services to business units in support of organizational objectives.

• Communicates direction for Credentialing Operations processes to managers, supervisors, and individual contributors, and ensures methods align with organizational goals and objectives.
• Analyzes the performance of company programs and initiatives to assess progress against goals.
• Formulates and implements strategy for the credentialing operations unit to support business objectives and initiatives.
• Counsels internal and external stakeholders on business review and credentialing services projects and issues.
• Drives the audit process including error correction and rebuttal.
• Reviews audit results for accuracy and provides guidance on items with critical business implications.
• Partners with network management and provider relations, provider services, health delivery associates, and other cross functional areas to manage provider/producer issues.
• Manages operational aspects of the team (e.g., budget, performance, and compliance), and implements workforce and succession plans to meet business needs.
• Responsible for managing a team up to 20 employees.

REQUIRED QUALIFICATIONS

• A minimum of 5 years working with provider data, network, relations, or credentialing.
• A minimum of 3 years managing/leading a team.
• Experience working in Medicare, Medicaid, or Commercial Health Insurance.

PREFERRED QUALIFICATIONS

• Experience working in credentialing operations.
• Strong written and verbal communication.

EDUCATION

• Bachelor’s degree preferred or a combination of professional work experience and education.

Please refer the Job description for details