Nashville, TN, 37230, USA
6 hours ago
Sr. Coordinator, Credentialing & Physician Mgt
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 Coordinator is responsible for initial credentialing and re-credentialing nurse practitioners, physician assistants and physicians in a compliant and timely manner; monitor expired credentials and compliance monitoring in accordance with Joint Commission accreditation, NCQA and URAC credentialing standards as required. • Responsible for the timely and accurate processing of all providers including NP’s/PA’s/MD’s initial and Re-credentialing applications according to the Minute Clinic Provider Credentialing Program • Monitor Expired licensure reporting , data base tasks and maintain system updates and weekly reporting to leadership • Manage Epic access for any providers that have out of compliance licensure and/or board certification. • Conduct sanctions and compliance monitoring and alert Credentialing Manager and Revenue Director of any undisclosed negative findings • Process malpractice insurance verification requests according to internal policies • Maintain the provider and physician SharePoint sites and Communicate provider status’s with leadership and other internal teams to meet timelines • Submit system access requests upon credentialing approvals/clinic eligibility • Support the payer enrollment team as needed to resolve any payer claim issues • Monitor Provider and Clinic change/Termination reports and update data base accordingly • Process Name changes according to Minute Clinic policies and procedures • Daily maintenance of provider credentialing grids with notification to appropriate teams • Review and distribute all incoming mail as needed • Support Payer Audits in accordance with Minute Clinic, Joint Commission and NCQA requirements • Maintain provider files with the most current information/documentation • Notify system analyst and leadership of any system and state agencies interruptions/updates/password changes • Make recommendations for process improvement and system efficiencies • Attend and engage in all team meetings • Model a positive attitude in interactions with team members and willing to work on a fast pace environment **Required Qualifications** • Demonstrate understanding of initial credentialing and re-credentialing practices for medical professionals including primary source verification methods, compliance monitoring and expirable management. • Proficient in quantitative data analysis • Understanding of Joint Commission Accreditation, NCQA and URAC credentialing standards. • Ability to function independently and utilize critical thinking skills to accomplish goals and objectives • Effective communication skills; verbal and written • Strong interpersonal skills including the ability to work well with internal and external stakeholders • Strong organizational skills and the ability to multitask • Competent user of Microsoft Office, Outlook, Word, and Excel • A minimum of 3 years experience in the healthcare industry with experience in credentialing **Preferred Qualifications** • NAMSS Certified Professional Credentialing Specialist (CPCS) certification. • Associates or Bachelor in business preferred **Education** • Verifiable High School Diploma is required. • Associates or Bachelor in business preferred. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $18.50 - $31.72 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: + **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: 09/08/2025 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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