Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary
- Maintains high production and quality factors.
- Participates in development of credentialing processes and workflows.
- Identifies improvement opportunities and recommends enhancements and workable solutions.
- Provides telephonic education to providers/producers on credentialing policies and procedures.
- Identifies and communicates trends (quality of results, efficiencies of processes).
- Researches and prepares risk sensitive or complex business review/credentialing verification items for CPC.
- Reviews completed investigative files of co-workers for completion and accuracy. Manages vendor online access of primary verification sources. Provides ongoing support to department members in completing research and analysis to resolve complex issues raised by providers/producers and other internal/external customers.
- Directly contacts providers/producers and/or outside entities to clarify data quality issues.
- Provides issue resolution for providers/producers, during the credentialing or data management processes.
- Responds to network or provider/producer inquiries, including contracting and credentialing policy, procedures, credentialing status.
- Perform data entry and systems maintenance as needed; align data across systems.
- Ongoing License Sanction monitoring and reporting to minimize corporate risk.

Required Qualifications
- 1+ years of Credentialing experience

-1+ years of Provider Data Service experience

Demonstrated track record of prioritizing work, multi-tasking, and managing workload efficiently.

- 1 +years of Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel

Preferred Qualifications
- QNXT experience
- Ability to consistently meet and/or exceed performance/production goals

Education- High School Degree or G.E.D.

Pay Range

The typical pay range for this role is:

$17.00 - $28.45

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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 09/11/2024

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