Credentialing Senior Specialist Job at CVS Health

Digital Assurance Senior Specialist

We are currently looking for a Digital Assurance Senior Specialist to join our I...

Location

Greece , Athens

Salary:

Not provided

Metlen Group

Expiration Date

Until further notice

Requirements

Bachelor’s degree in Computer Information Systems, Engineering, Finance, Business Administration, or a related field
7+ years of client-facing experience delivering Digital Assurance services, with a background in Cyber/IT audit, SOX IT audits, and IT risk advisory
Hands-on experience auditing IT general controls, financial IT systems (e.g. Windows, Linux, SAP, Oracle, SQL), and cloud environments (e.g. AWS, Azure, AI tools)
Familiarity with IT standards and frameworks such as ISO 27001, COBIT, NIST, NIS2, and the AI Act
Certified in CISA, CRISC, CGEIT, CISM, ITIL, ISO 27001/LA, or similar credentials
Skilled in agile ways of working, sprint management, stakeholder engagement, and producing high-quality reports
Strong analytical, communication, and problem-solving skills, with a high sense of confidentiality
Fluent in English and willing to travel both in Greece and internationally

Job Responsibility

Apply the Internal Audit strategy/policies, update the Digital Audit and Assurance strategy and prepare the Digital Assurance annual plan
Participate in digital assurance engagements, ensuring the delivery of high-quality, tech-enabled solutions
Collaborate with business units to understand their systems and technologies and provide recommendations to mitigate risks
Develop and utilize GRC, data analytics and other innovative tools to help business units identify, assess and manage risk and controls during their transformation journey
Work closely with external audit teams and internal cybersecurity teams to ensure comprehensive risk management
Stay updated with emerging technologies (e.g., cloud, AI, cybersecurity) and provide insights to integrate them into client solutions
Provide mentorship to junior team members, fostering a culture of continuous learning and improvement

What we offer

Competitive remuneration package
Ticket Restaurant Card
Group Health Insurance Plan
Preferential household electricity plan
Pension Plan

Fulltime

Senior Credentialing Specialist

The Senior Credentialing Specialist is responsible for the credentialing and rec...

Location

United States

Salary:

61300.00 - 99620.00 USD / Year

Healthfirst

Expiration Date

Until further notice

Requirements

5+ years of proven credentialing experience
Facilities experience
Bachelor’s degree or equivalent combination of education and experience
Proficiency in MS Word, Excel, Outlook
Superior organizational and follow up skills
Strong attention to detail

Job Responsibility

Perform primary source verifications and query necessary databases including but not limited to the following: CAQH, NPDB, NSCH, ABMS, AOA, AMA, etc
Perform credentialing and recredentialing of non-delegated providers and vendors, facilities and groups in accordance with established credentialing policies and procedures and NYS and CMS credentialing regulations
Work collaboratively with Vendor Management Specialist and designated Credentialing Verifications Organization (CVO) and audit monthly files
Prepare, review, update and/or audit committee summaries and present them to the Credentialing Committee as applicable
Participate in internal and external meetings to respond to inquiries and define credentialing requirements for stakeholders
Troubleshoot issues and outreach to necessary internal and external contacts as required to obtain credentialing and recredentialing documents
Actively participate with and support the development of internal provider systems used to intake, track and monitor provider credentialing
Develop job aids, workflows, and policies as procedures and systems evolve
Prepare bi-weekly clean file approval lists for medical directors
Additional duties/tasks as assigned

What we offer

Medical, dental and vision coverage
Incentive and recognition programs
Life insurance
401k contributions

Fulltime

New

Credentialing Specialist II-Medical Staff

Performs and monitors all credentialing functions, including complex credentiali...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED)
Two (2) to Four (4) years of medical staff privileging or credentialing experience
CPCS or CPMSM certification preferred
Intermediate to Advanced Knowledge of healthcare practices and procedures
Advanced Skills in maintaining a detailed database, creating reports, and maintaining files
Intermediate to Advanced Ability to read, analyze, and interpret general business periodicals, professional journals, technical and software related procedures and manuals, governmental regulations
Display promotes and inspires trust and confidence among team members and stakeholders through reliability, authenticity, and accountability
Expresses thoughts clearly, concisely, and effectively both verbally and in writing
Establishes and maintains productive and cooperative relationships with team members, peers, management, and stakeholders both internal and external to the organization
Intermediate to Advanced ability to effectively present information and respond to inquiries regarding any issue related to the Credentialing and Privileging process

Job Responsibility

Performs and monitors all credentialing functions, including complex credentialing issues and brings forward issues to the Medical Staff Credentialing Lead and/or Director
Interfaces with senior medical staff leaders and administration and presents information when necessary
Utilizes knowledge of bylaws, rules, and regulations, expertise, sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Acts as a liaison between Administration and members of the Medical Staff
Apply knowledge, expertise, sound judgment and consult other references and resources as necessary to generate and evaluate solutions and recommendations
Applies knowledge of bylaws, rules, and regulations to effectively serve as a Medical Staff information resource, to ensure timely flow of work, and sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Ensures compliance with all applicable Accreditation agencies
Supports oversite and participate in internal, external, compliance surveys, reviews and audits as required
Utilizes credentialing software for new and reappointment letters, resignations, leave of absences, changes in staff category, add/delete privileges
Coordinates, monitors and maintains the credentialing and recredentialing process

Fulltime

Senior Payroll Specialist

Our client a cutting-edge publicly traded company in Montgomery County is lookin...

Location

United States , Silver Spring

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent credential required
Experience working within Workday as a core payroll or HRIS system
Minimum of 5 years of hands-on experience managing end-to-end payroll processing for a workforce of 600+ employees
Familiarity with additional payroll and ERP platforms (e.g., SAP or cloud-based payroll solutions)
Working knowledge of payroll accounting concepts, including the preparation of journal entries
Strong analytical skills with the ability to interpret data and resolve complex payroll issues
Experience generating reports and summarizing data for internal stakeholders
Adaptable and flexible in a fast-paced, deadline-driven environment
Maintains composure and effectiveness in high-pressure situations
Comfortable balancing multiple tasks and shifting priorities as business needs evolve

Job Responsibility

Validate and audit employee data updates flowing into the payroll platform to ensure accuracy and completeness
Coordinate the timely submission and approval of employee time records, following up with employees and managers as needed
Manage a shared payroll inbox, addressing questions and requests within established service-level timelines
Investigate, troubleshoot, and resolve payroll discrepancies and inquiries with a high degree of accuracy and urgency
Administer wage garnishments and related support orders in compliance with applicable requirements
Maintain well-organized and up-to-date payroll documentation and records
Compute, reconcile, and process retroactive and advance payroll adjustments as necessary
Review payroll system integrations and interfaces, identifying and resolving errors on scheduled processing days
Prepare and distribute payroll-related reports and data summaries for internal partners upon request
Perform additional payroll-related responsibilities as assigned

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Senior Salesforce Administrator

We are looking for a Senior Salesforce Administrator to take a lead role in the ...

Location

United Kingdom , London

Salary:

Not provided

The Telegraph

Expiration Date

Until further notice

Requirements

Strong, hands-on experience configuring Service Cloud in a complex environment
Expert-level Flow creation, troubleshooting, and optimisation
Experience with deployments, change sets/devops tooling, and sandbox management
Ability to design scalable, maintainable solutions that follow platform best practices
Strong understanding of Salesforce data structures, APIs, and error-handling principles
Experience with Omni-Channel, case assignment routing, and automation around service operations
Experience working with Agentforce / AI Agents or a strong ability to learn rapidly
Familiarity with Einstein for Service tools (Email Drafts, Case Wrap-Up, Article Recommendations, Case Classification)
Ideally holds Agentforce Specialist certification or relevant Trailhead credentials
Proven experience in a senior admin or advanced second-line Salesforce role

Job Responsibility

Act as a senior system administrator across TMG’s Salesforce platform, with ownership of advanced BAU tasks and complex support requests
Design, build, debug, and optimise Flows, orchestrations, automations, and error-handling frameworks
Lead the investigation and resolution of complex issues, including failures in integrations, flows, API-driven processes, and subscription logic (Zuora/MPP)
Oversee release management alongside developers, including participating in deployment rota, validating builds, and ensuring sandboxes remain aligned with production
Lead the configuration and expansion of Agentforce for Service
Support the rollout of Einstein for Service capabilities
Stay current with rapidly evolving AI features and help guide internal adoption
Work closely with our developers and QAs on solution design, technical refinement, and deployment readiness
Partner with the business to translate requirements into actionable Salesforce solutions that are scalable and maintainable
Document configuration, logic, and release steps in Jira/Confluence

What we offer

Dynamic working opportunities
Medical cover
Parental leave (six months fully paid maternity leave and enhanced paternity/partner leave)
Life assurance
Season ticket loans
Flexible benefits designed to support your lifestyle and help you achieve a healthy work-life balance
Access to a variety of training and development opportunities through The Academy

New

Senior Field Reimbursement Specialist

Under general supervision of a Senior Manager, the Sr Field Reimbursement Specia...

Location

United States , Remote

Salary:

100700.00 - 155100.00 USD / Year

Cencora

Expiration Date

Until further notice

Requirements

Experience related and progressively responsible in a medical practice, private or third-party reimbursement arena, or pharmaceutical industry in sales, managed care, or clinical support
Experience within healthcare provider support such as a physician practice, patient assistance program or similar pharmaceutical/biological support program experience preferred
Bachelor’s degree preferred
Minimum of 7 years of experience
Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials from an industry approved licensing body, or obtain certification within the first six months of employment
Ability to effectively manage multiple client relationships and customer
Ability to manage and support external meetings, presentations, and client interactions
Ability to lead and work in a matrix environment
Proven teamwork and collaboration skills with a demonstrated record of accomplishment of working in highly matrixed and cross-functional organizations
Ability to manage multiple tasks, timelines, expenses, and other activities necessary to fulfill the roles and responsibilities of a Field Reimbursement Specialists

Job Responsibility

Plan and engage with customers, leveraging client approved resources, to educate on access and reimbursement topics relevant to assigned client’s product
Track progress and evaluate results of assigned activities
Recommends changes in procedures
Lead or direct more complex projects or certain aspects of projects
Operates with reasonable latitude for un-reviewed action or decision
Work within a matrix environment to collaborate with internal and external stakeholders to secure optimized patient access and provide appropriate education through a focused effort on healthcare providers in community, institutional, and academic medical settings
Manage daily activities that support appropriate patient access to our client’s products in the provider offices and healthcare institutions, working as a liaison to other patient assistance and reimbursement support services offered by our clients
Review patient insurance benefit options with appropriate authorizations
Validate prior authorization requirements
Understanding of Specialty Pharmacy processes

What we offer

medical
dental
vision care
comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness
support for working families
backup dependent care
adoption assistance
infertility coverage
family building support
behavioral health solutions

Fulltime

Supervisor Medical Staff Services

Leads, plans, organizes and is responsible for the day to day operations of the ...

Location

United States

Salary:

30.70 - 46.05 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Credentialing Specialist, Certified Provider (CPCS) issued by the National Association Medical Staff Services (NAMSS), or Medical Services Management, Certified Professional (CPMSM) issued by the National Association Medical Staff Services (NAMSS)
Bachelor's Degree in Health Care Administration or related field
Typically requires 3 years of experience in medical staff services, credentialing, physician relations, regulatory, with experience as a lead or senior level staff
Excellent interpersonal and communication skills including both verbal and written
Ability to use of variety of software and credentialing database
Demonstrated time management and task delegation skills
Ability to work as a team member in a fast paced environment with multiple tasks requiring completion within short timeframes
Position requires high degree of judgment and ability to think independently

Job Responsibility

Implements, coordinates, monitors, and maintains effective credentialing processes for the process of appointment, reappointment and credentialing for the designated medical staff organizations
Serves as resource person on credentialing/privileging, bylaws, policies governing medical practice, and other related matters to the medical staff
Assists in the development and implementation of medical staff policies and procedures as needed and updates as appropriate relating to credentialing
Provides support regarding issues involving Medical Staff Professionalism including wellness, corrective action and fair hearing processes
Provides accurate and timely reports to the medical staff, governing council and system governing board regarding all aspects of the credentialing and privileging process including any related reports
Develops and implements departmental workflows, policies and procedures, standards of practice, manuals, forms, etc., as needed and updates as appropriate
Manages operations of the Medical Staff Services Department and provides oversight and direction to staff
Performs human resources responsibilities for staff which includes coaching on performance, completes performance reviews and overall staff morale
Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Supervisor Medical Staff Services

Leads, plans, organizes and is responsible for the day to day operations of the ...

Location

United States

Salary:

30.70 - 46.05 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Credentialing Specialist, Certified Provider (CPCS) issued by the National Association Medical Staff Services (NAMSS), or Medical Services Management, Certified Professional (CPMSM) issued by the National Association Medical Staff Services (NAMSS)
Bachelor's Degree in Health Care Administration or related field
Typically requires 3 years of experience in medical staff services, credentialing, physician relations, regulatory, with experience as a lead or senior level staff
Excellent interpersonal and communication skills including both verbal and written
Ability to use of variety of software and credentialing database
Demonstrated time management and task delegation skills
Ability to work as a team member in a fast paced environment with multiple tasks requiring completion within short timeframes
Position requires high degree of judgment and ability to think independently

Job Responsibility

Implements, coordinates, monitors, and maintains effective credentialing processes for the process of appointment, reappointment and credentialing for the designated medical staff organizations
Serves as resource person on credentialing/privileging, bylaws, policies governing medical practice, and other related matters to the medical staff
Assists in the development and implementation of medical staff policies and procedures as needed and updates as appropriate relating to credentialing
Provides support regarding issues involving Medical Staff Professionalism including wellness, corrective action and fair hearing processes
Provides accurate and timely reports to the medical staff, governing council and system governing board regarding all aspects of the credentialing and privileging process including any related reports
Develops and implements departmental workflows, policies and procedures, standards of practice, manuals, forms, etc., as needed and updates as appropriate
Manages operations of the Medical Staff Services Department and provides oversight and direction to staff
Performs human resources responsibilities for staff which includes coaching on performance, completes performance reviews and overall staff morale
Responsible for understanding and adhering to the organization's Code of Ethical Conduct and for ensuring that personal actions, and the actions of employees supervised, comply with the policies, regulations and laws applicable to the organization's business

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance

Fulltime

Credentialing Senior Specialist

CVS Health

Location:
United States

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
February 25, 2026

Expiration:
March 13, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Credentialing Senior Specialist

Digital Assurance Senior Specialist

Senior Credentialing Specialist

Credentialing Specialist II-Medical Staff

Senior Payroll Specialist

Senior Salesforce Administrator

Senior Field Reimbursement Specialist

Supervisor Medical Staff Services

Supervisor Medical Staff Services

Credentialing Senior Specialist

CVS Health

Location:United States

Category:IT - Administration

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:February 25, 2026

Expiration:March 13, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Credentialing Senior Specialist

Digital Assurance Senior Specialist

Senior Credentialing Specialist

Credentialing Specialist II-Medical Staff

Senior Payroll Specialist

Senior Salesforce Administrator

Senior Field Reimbursement Specialist

Supervisor Medical Staff Services

Supervisor Medical Staff Services

Location:
United States

Category:
IT - Administration

Contract Type:
Not provided

Job Posted:
February 25, 2026

Expiration:
March 13, 2026