Credentialing & CVO Team Lead - Remote

Overview

We are actively seeking an experienced and strategic professional to take on the role of Credentialing and Credential Verification (CVO) Team Lead. This role provides a significant learning & growth opportunity for someone who is looking to expand their experience in consultative credentialing services working with top talent across the globe.

In Short

• End to end Licensing/ CVO, Credentialing and Privilege processes to ensure compliance with industry standards and regulations.
• Process physician accreditation, managed care, governmental and commercial insurance enrollment and re-credentialing.
• Daily provider data management and review of credentialing files for accuracy and completeness.
• Analyze local payor IPA markets for partnerships or payer contracting opportunities.
• Perform primary source verification via various state and national sources.
• Oversees, updates and maintains provider credential database.
• Develops and prepares analytical reports monthly/quarterly of the summary of credentialing activity.
• Mentor and coach the team to provide highest levels of service and efficiency.
• Maintain relationships with key Payers to facilitate negotiation of contracts.
• Collaborate with internal departments to streamline and optimize credentialing operations.

Requirements

• Bachelor's degree in healthcare administration, Business, or a related field; master's degree preferred.
• 3 - 5 years of experience in credentialing, with substantial experience in Leadership.
• In-depth knowledge of credentialing processes, privileging, and regulatory requirements.
• Established relationship with key payers will be a plus.
• Strong organizational and project management skills.
• Excellent communication skills.
• Skilled in preparing and delivering presentations to C Suite stakeholders.

Benefits

• Significant learning & growth opportunity.
• Collaborative and innovative healthcare environment.
• Opportunity to make a significant impact on the organization.