Senior Credentialing Operations Manager

CVS Health • Providence, RI • 11h ago

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.

Pay Range

The typical pay range for this role is:

$67,900.00 - $199,144.00

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. This position also includes an award target in the company's equity award program.

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:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 09/20/2025

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

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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