Credentialing Sr. Specialist

CVS Health • Chicago, IL

2d • $19 - $39 • Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Company: Oak Street Health Title: Delegated Credentialing Associate Location: Remote; Treehouse Role Description The Delegated Credentialing Associate will work closely with our licensed providers to onboard,maintain, and re-credential our providers in all OSH markets. The role will include supporting the primary source verification processes and working closely with external agencies. On behalf of our physicians, you will provide formal, detailed documentation of their professional histories to these groups, and thoroughly track the process to ensure follow-through from start to finish. Experience should include responsibility for medical and professional credentialing processes, policies and procedures and delegated credentialing requirements.

Requirements

• A minimum of 1 to 2 years prior credentialing experience in the Managed Care, CVO or Hospital setting
• We are looking for specific knowledge of Primary Source Verification (PSV) and preparation of a provider files for credentialing committee
• Knowledge of credentialing accreditation standards such as NCQA, Joint Commission, or CMS
• Experience Working with provider rosters and provider data
• Knowledge of third party credentialing systems such as CAQH, Availity, CMS (NPPES and PECOS)
• All candidates should have professional written and verbal communication skills
• Attention to detail and strong organizational skills
• High level of integrity and work ethic
• U.S. work authorization
• Someone who embodies being “Oaky”

Nice To Haves

• Prior experience working in credentialing systems such as CredentialStream (Vertity), Credential MY Doc, Ecco One App, MD Staff is preferred

Responsibilities

• Maintaining multiple databases with highly sensitive physician information while streamlining the paperwork process.
• Assisting with provider onboarding to confirm receipt of required documents.
• Preparing provider credentialing applications for committee
• Monitor the renewal of all applicable licensure, certifications, and insurance policies such as state licensure, board certification, DEA licenses and enrollment with CMS
• Providing regular updates on credentialing progress to other teams within Oak Street Health.
• Responsible for maintaining all aspects of the CAQH credentialing application and verification process for initial and re-credentialing requests.
• Assures all practitioner data is accurate and up to date in our credentialing software application, including generating and monitoring reports
• Perform other related duties as assigned.

Benefits

• Mission-focused career impacting change and measurably improving health outcomes for medicare patients
• Paid vacation, sick time, and investment/retirement 401K match options
• Health insurance, vision, and dental benefits
• Opportunities for leadership development and continuing education stipends
• New centers and flexible work environments
• Opportunities for high levels of responsibility and rapid advancement
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed