Senior Credentialing Specialist

Network Activation Sr. Credentialing SpecialistWe'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.Position Summary:The Network Activation Sr. Credentialing Specialist supports network operations, compliance monitoring, and provider data integrity. The role ensures network providers comply with company, state, and regulatory body requirements, including NCQA, URAC, Medicare, Medicaid, and delegation agreements, by reviewing, validating, and analyzing provider information. The Sr. Credentialing Specialist also drives process improvements, handles stakeholder inquiries, and provides administrative and operational support to meet departmental needs.Roles & Responsibilities:Support diverse network activation projects and operations to ensure department-wide compliance and efficiency.Act as primary liaison for clinicians and internal departments to support communication, address inquiries, and resolve issues.Conduct ongoing verification and monitoring of state licenses, exclusion lists, DEAs, board certifications, and enrollment data to validate provider standing.Manage clinician enrollment, state licensure applications, and renewals according to state and federal guidelines.Ensure strict adherence to business, state, and accrediting body regulatory requirements, including NCQA, URAC, Medicare, Medicaid, and delegation agreements.Maintains data tracking and facilitates provider data integrity across organizational units.Prepare education and training materials on Network Activation policies, procedures, and quality standards, and conduct training to enforce standards.Drive process improvement initiatives, manage stakeholder inquiries, and execute administrative and operational support to accommodate flexible departmental needs.Required Qualifications:3-5 years of successful work experience in a Network Activation or credentialing role/departmentPreferred Qualifications:Candidates local to the Dallas area who can commute to the Signify Health headquarters in Farmers Branch are preferred.NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify.Intermediate skills in Google Suite Applications such as Gmail, Google Calendar, Google Sheets and Slide PresentationsEducation:High School DiplomaAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$18.50 - $35.29This 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.Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.This full?time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well?being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on Benefits Moments.We anticipate the application window for this opening will close on: 11/29/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.