Credentialing Sr Specialist

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 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. Other responsibilities include:

• 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.

Required Qualifications

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

What does being “Oaky” look like?

• Radiating positive energy
• Assuming good intentions
• Creating an unmatched patient experience
• Driving clinical excellence
• Taking ownership and delivering results
• Being relentlessly determined

Why Oak Street Health?
Oak Street Health is on a mission to “Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient’s communities, and focused on the quality of
care over volume of services. We’re an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody “Oaky” values and passion for our mission.

Oak Street Health 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

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $38.82

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 b