Summary:In this role you will lead a high-impact Credentialing Operations unit dedicated to accelerating clinician "speed-to-market." This role moves beyond administrative oversight to drive the strategic evolution of credentialing workflows, ensuring the department serves as a proactive partner in meeting organizational growth targets and resolving complex, high-stakes provider barriers.
Key Responsibilities:- Strategic Roadmapping: Formulates and implements a forward-looking strategy for the Credentialing Operations unit, transforming the department from a transactional function into a strategic lever that directly supports national clinician deployment goals.
- Escalation Management: Serves as the final point of resolution for complex, high-priority credentialing issues; counsels internal leadership and external stakeholders on critical business reviews and high-stakes credentialing bottlenecks.
- Performance Engineering: Analyzes the efficacy of credentialing programs, utilizing business intelligence to move beyond standard goal-tracking toward identifying systemic opportunities for process acceleration.
- Audit & Risk Mitigation: Drives a sophisticated audit and rebuttal framework; reviews results for accuracy while providing executive-level guidance on findings with significant business or legal implications.
- Cross-Functional Advocacy: Acts as the primary operational liaison to Network Management, Provider Relations, and Tech teams, ensuring that credentialing barriers are proactively addressed through cross-functional initiatives and shared accountability.
- Workflow Evolution: Sets the direction for continuous process evolution, ensuring that credentialing methods are agile enough to support shifting organizational objectives and diverse clinician types (e.g., National Travelers).
- Strategic Workforce Planning: Manages all operational facets of the team-including budget, performance metrics, and compliance-while architecting workforce and succession plans to ensure long-term departmental resilience.
- Compliance Leadership: Ensures all credentialing strategies maintain strict alignment with regulatory standards while minimizing friction in the clinician onboarding experience.
Basic Qualifications:- A Bachelor's degree is preferred (Healthcare Administration, Health Information Management, Public Health, Health Services, Business Administration, or related fields). Specialized training or relevant professional experience will also be considered
- 5+ years of leadership experience in a high-volume credentialing or medical staff services environment
- Mastery of Strategic Problem Solving: Exceptional ability to navigate "gray areas" and make high-consequence decisions under pressure
- Adept at Business Intelligence: Skilled at using data to forecast "time-to-credential" and identify long-poles in the onboarding funnel
- Growth Mindset & Agility: Proven track record of developing talent and evolving organizational structures to meet the demands of a high-growth healthcare environment
- Executive Presence: Professional demeanor capable of influencing senior leadership and resolving sensitive provider issues with diplomacy and authority
Anticipated Weekly Hours40
Time TypeFull time
Pay RangeThe typical pay range for this role is:
$75,400.00 - $165,954.00
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.
Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 06/30/2026
