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 CVS Business Unit: Signify Health Location / Logistics: This role is open to remote candidates, but preference is for candidates in Dallas, TX area that can work Hybrid every other Tuesday in office. (In office schedule is subject to change based on business needs.) Our Dallas offices are located at: 4055 Valley View Ln #700, Dallas, TX 75244 Position Summary The Senior Credentialing Specialist ensures all credentialing functions comply with internal policies, client contracts, URAC guidelines, NCQA standards, and all applicable state and federal
requirements. This position provides guidance to staff and customers, helps manage workflow improvement projects, and handles non-routine business support tasks with limited supervision. Key
Responsibilities Serve as a subject matter expert on credentialing for internal staff and external customers. Prepare and provide education and training to Credentialing Specialists on credentialing policies and internal processes. Organize and conduct ongoing audits to evaluate compliance with standards, outcomes, and deliverable timelines. Review and process new clinician credentialing and re-credentialing files if required based on business needs. Perform primary source verifications by querying appropriate organizations (e.g., state boards, NPDB) and evaluating responses to ensure compliance. Assemble all verified information and prepare files for presentation to the Credentialing Committee. Maintain accurate copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents. Review all background checks, drug tests, and TB screenings and record the results. Utilize the MD Staff credentialing database to perform queries, generate reports, and optimize efficiency. Assist with the ongoing monitoring of contracted clinicians. Maintain responsibility for the security and privacy of any protected health information (PHI) accessed during work activities. Provide administrative support to department leadership and stakeholders. Actively demonstrate teamwork and assist with special projects. Required
