About the role
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Requisition Job Description The Credentialing Quality Supervisor oversees the day-to-day activities of the Senior Credentialing Specialists who are responsible for auditing the quality and accuracy of all applications reviewed by our credentialing team. You will play a critical role in maintaining our high standards by ensuring error-free processing and compliance. The Supervisor will maintain strong cross-departmental relationships with Credentialing Operations, Recruiting, and Compliance. This role will report to our Operations Manager. Diversity and Inclusion are core values at Signify Health and fostering a workplace culture reflective of that is critical to our continued success as an organization. What will you do? Oversee Quality Operations: Manage the daily workflow of the Senior Audit Specialists to ensure timely and accurate completion of quality reviews for all credentialing and re-credentialing applications. Reporting (KPIs and Metrics): candidate will be responsible for pulling and analyzing regular reports to monitor team performance and operational metrics. You will be expected to utilize specific internal systems to extract data, identify trends, and provide actionable insights to leadership. Ensure Compliance: Oversee the audit process to ensure provider files strictly adhere to Federal, State, NCQA, and client policy
requirements associated with delegated credentialing. Team Leadership: Provide guidance, coaching, and regular performance feedback to the senior audit team to align with individual, department, and company goals. Training & Development: Train new Senior Specialists on the credentialing audit process, quality standards, error-reporting procedures, and NCQA guidelines. Meets with Ops Mgr regularly to provide updates, reporting and feedback. Drive Continuous Improvement: Analyze audit data to identify error trends, processing bottlenecks, and training opportunities for the broader credentialing team to improve overall quality. Act as an Escalation Point: Serve as the final reviewer for complex credentialing audits, discrepancies, or appeals regarding additional verifications (such as State Board Licenses and Department of Defense requests). Project Management: Lead and assist with special projects to support quality operations and operational needs as directed by management. Required
