Senior Manager, Credentialing Operations
Hartford, CT · HybridFull-time$83–183K/yrPosted 1w agoStill listed 6 days ago
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At a glance
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Job overview
The Senior Manager, Credentialing Operations leads CVS Health’s Credentialing Verification Organization services, overseeing production, quality, reporting, ongoing monitoring, and process improvement. The role ensures accurate, compliant provider credentialing data across multiple lines of business and supports provider network quality. It advances health plan objectives through operational excellence, regulatory compliance, data-driven insights, cross-functional collaboration, and timely credentialing decisions that support member access to care.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
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.
The Senior Manager, Credentialing Operations is the leader of critical functions within the Credentialing Verification Organization (CVO) and is accountable for the delivery of credentialing services, including production, quality, reporting, ongoing monitoring, and continuous process improvement. This role ensures the accuracy, integrity, and compliance of provider credentialing data across multiple lines of business, supporting the development and maintenance of a high-quality provider network.
This leader plays a key role in advancing health plan objectives by driving operational excellence, regulatory compliance, quality outcomes, and provider experience. Through collaboration with cross-functional partners, the Senior Manager leverages data-driven insights, process optimization, and strategic execution to improve credentialing performance, enhance service delivery, and ensure timely, accurate credentialing decisions that support member access to care.
Key Responsibilities
- Leads a business services unit that delivers credentialing services in support of organizational objectives.
- Establishes and communicates strategic direction for Credentialing Operations and ensures processes align with enterprise goals and priorities.
- Analyzes operational performance metrics and key initiatives to evaluate progress against business objectives and identify opportunities for improvement.
- Develops and implements strategies that enhance operational effectiveness, quality, compliance, and service delivery.
- Serves as a trusted advisor to internal and external stakeholders on credentialing operations, business reviews, and related initiatives.
- Leads audit activities, including issue identification, corrective action planning, error remediation, and rebuttal management.
- Reviews audit findings for accuracy and provides guidance on issues with significant business or regulatory implications.
- Partners with Network Management, Provider Relations, Provider Services, Health Delivery teams, and other cross-functional stakeholders to address provider-related issues and improve operational outcomes.
- Drives continuous improvement initiatives that streamline processes, reduce risk, and enhance the provider and customer experience.
- Fosters a culture of accountability, collaboration, innovation, and high performance.
Required Qualifications
- Minimum of 5 years of experience in provider data management, provider network operations, provider relations, credentialing, or a related healthcare operations function.
- Minimum of 3 years of experience leading and developing teams.
- Experience working in credentialing operations.
- Knowledge of and experience supporting Medicare, Medicaid, and/or Commercial Health Insurance lines of business.
- Strong analytical, problem-solving, and decision-making skills.
- Demonstrated ability to influence stakeholders and drive results across cross-functional teams.
- Strong written and verbal communication skills.
Preferred Qualifications
- Experience leading operational transformation or continuous improvement initiatives.
- Experience working within a Credentialing Verification Organization (CVO) environment.
- Experience utilizing data and metrics to drive operational performance and business decisions.
- Proven ability to manage multiple priorities in a fast-paced, highly regulated environment.
Education
- Bachelor's degree or equivalent work experience
Pay Range The typical pay range for this role is:
$82,940.00 - $182,549.00 This 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. This position also includes an award target in the company’s equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We 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: 11/09/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
How this job compares
Set against the 1,043 open Healthcare Operations jobs on Olive Jobs, counted November 6, 2026.
- Pay
- This posting$83–183K/yr
- US median$99–158K/yr534 salary ranges
This range's midpoint, $133K, is close to the US median midpoint ($134K) — in the middle half of Healthcare Operations salary ranges across the US.
- Openings
- Olive Jobs lists 16 open Healthcare Operations jobs in Connecticut and 1,043 across the US. 8% of them nationwide are listed as remote or flexible.
- Hiring the most across the US
- Compass Group, North America76 open
- CenterWell57 open
- CVS Health (this employer)46 open
- Experience
- This posting asks for at least 5 years of experience; Healthcare Operations postings that state a minimum ask for 5 years at the median (879 postings).
- Education
- 336 of the 1,043 open Healthcare Operations jobs (32%) ask for a bachelor's degree or higher.
Counted across the open, public US postings on Olive Jobs on November 6, 2026. Pay medians are the middle values of the low ends and of the high ends of postings that list both ends of a range in the same cadence (a yearly salary or an hourly rate); a range's midpoint is halfway between its ends. Pay and experience figures resting on fewer than 20 postings are left out.
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