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Credentialing Specialist

4 months ago

Salt Lake City, United States CVS Health Full time

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 The Credentialing Specialist is responsible for monitoring state and federal sources for exclusions, debarments, and reinstatements for our Medicaid providers (individual and facility providers). The Credentialing Specialist will also perform primary source verifications as needed for sanctioned providers. This is completed through outreach to external resources, internal data tapes and systems. The Credentialing Specialist works federal and state agency contacts and various internal business and system partners, and is responsible for completing all assigned tasks within guidelines of in internal or state metrics while maintaining all quality expectations. Additional Duties Performs data collection, analytical research and analysis. Must have the ability to handle multiple processes Tracks and monitors individual work against timeline and metrics. Actively participates in team meetings. Ability to learn and adapt to multiple databases and websites Required Qualifications 1+ years of Credentialing or Provider Data Services experience Working knowledge of Microsoft Outlook, Word, and Proficient in Excel. Ability to physically read legal documents from licensing boards. Preferred Qualifications 1 year of experience working in EPDB Strong desk management skills. Strong reading comprehension skills. Education High School Diploma or GED Pay Range The typical pay range for this role is: $17.00 - $29.88 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 jobs.CVSHealth.com/benefits We anticipate the application window for this opening will close on: 06/12/2024 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.