Credentialing Specialist

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

The Credentialing Specialist ensures clinicians successfully pass the Signify Health credentialing process. This role is responsible for assisting clinicians with the completion of their credentialing applications , performing primary source verifications , and maintaining the MD Staff credentialing database. The Specialist must ensure all credentialing functions comply with internal policies, client health plan contracts, URAC guidelines, NCQA standards, and applicable state and federal requirements. This position reports to the Credentialing Supervisor.

Key Responsibilities

• Review and process credentialing and re-credentialing files.

Establish and maintain a system for the timely processing of credentialing files in accordance with NCQA policies.

Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers.

Assemble all verified information and prepare files for presentation to the Credentialing Committee.

Assist with the ongoing monitoring of contracted clinicians.

Provide administrative support to department leadership and both internal and external stakeholders.

Actively demonstrate teamwork and assist with special projects.

Required Qualifications

Preferred Qualifications

Education

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is :

$17.00 - $28.46

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include :

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We anticipate the application window for this opening will close on : 12 / 10 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.