CVO & Credentialing Specialist - Delegated Credentialing Job at Neolytix, Chicago, IL

M1k0NkVtYUxkT0g5Yy9hS2pKak1DTnV6Rnc9PQ==
  • Neolytix
  • Chicago, IL

Job Description

Job Title: CVO & Credentialing Specialist – Delegated Credentialing 

Company: Neolytix 

Location: Chicago, IL | Hybrid or Fully Remote (US-based) 

Experience Level: 4–6 Years 

About the Role 

Neolytix is seeking a CVO and Credentialing Specialist with deep expertise in delegated credentialing operations. You will manage end-to-end credentialing workflows for health system clients, perform primary source verifications, oversee quality control for our offshore operations team, and ensure NCQA compliance across all credentialing activities. 

This role combines hands-on credentialing work with team oversight and client coordination—ideal for someone who wants operational ownership, not just task execution. 

Key Responsibilities 

Primary Source Verification & Credentialing 

  • Perform PSV for licenses, board certifications, education, training, DEA, NPDB queries, OIG/SAM exclusion checks 

  • Manage initial credentialing and recredentialing workflows per NCQA standards 

  • Maintain audit-ready documentation for all verification activities 

Quality Control & Team Oversight 

  • Review and validate work performed by offshore credentialing analysts 

  • Identify errors, provide feedback, and drive process improvements 

  • Conduct spot audits to ensure accuracy and compliance 

Credentialing Committee Support 

  • Prepare provider files and committee packets for Credentials Committee review 

  • Coordinate scheduling and documentation with client Medical Staff Offices 

  • Document committee decisions and track follow-through items 

NCQA Compliance & Audit Readiness 

  • Maintain standards aligned with NCQA CVO requirements 

  • Support internal and external audits as subject matter expert 

  • Track turnaround times, clean file rates, and sanction monitoring metrics 

Client Coordination 

  • Serve as primary point of contact for assigned health system clients 

  • Provide regular status updates and escalate issues appropriately 

  • Build trusted relationships with client credentialing leadership 

Requirements 

Required: 

  • 4–6 years of medical credentialing or CVO operations experience 

  • Experience with delegated credentialing arrangements 

  • Strong working knowledge of NCQA credentialing and recredentialing standards 

  • Experience preparing for and supporting NCQA audits 

  • Exceptional attention to detail and organizational skills 

  • Strong communication skills—comfortable with client executives and offshore teams 

  • US-based 

Preferred: 

  • Certified Provider Credentialing Specialist (SPCS) certification 

  • Health system credentialing experience (not just payer-side) 

  • Experience with credentialing platforms (Cactus, Modio, MD-Staff, CredentialStream) 

  • Experience training or supervising remote/offshore teams 

Why Join Neolytix? 

You'll own credentialing operations for health system clients, not just execute tasks. We value precision, professional growth, and building scalable healthcare services. This role offers visibility across client operations, payer requirements, and our delivery model—a strong foundation for credentialing leadership. 

 

Job Tags

Full time,

Similar Jobs

Edwards Mail Service

Class A Mail Route Truck Driver Job Job at Edwards Mail Service

Class A Mail Route Truck Driver JobEdwards Mail Service hauls mail for the U.S.P.S. This is an Austin CDL 'A' local driving position. This position pays approximately 35 hours per week. Schedule is afternoons and overnight for mail delivery to Austin, TX postal facilities... 

Delta-T Group Inc.

Credentialing Specialist Job at Delta-T Group Inc.

 ...Location: Bryn Mawr, PA 19010 Date Posted: 12/30/2025 Category: Education: Delta-T Group is seeking a Credentialing Specialist to join our growing corporate team in Bryn Mawr. WHAT YOU WILL DO * Processes and tracks clearances (state child abuse clearance... 

Quality Home Care: Michigan Private Duty Aides

Social Worker or Psychologist - Discharge Planning Job at Quality Home Care: Michigan Private Duty Aides

Social Worker or Psychologist Discharge Planning Location: Plymouth, MI | Onsite Schedule: Full-Time | Hourly Position Summary...  ...safe, effective discharge planning for residents in a Skilled Nursing Facility. Works collaboratively with the interdisciplinary team... 

Westgate Resorts

Security Officer Job at Westgate Resorts

 ...continue growing, we will continue offering the best and most-affordable vacation options out there! Job Description As a Security Officer , you help keep our corporate offices safe, secure, and welcoming. This role blends security responsibilities with... 

804 Technology

Teamcenter Administrator Job at 804 Technology

 ...customer service skills. JOB RESPONSIBILITIES: Own Teamcenter Administration for the Bell enterprise, consulting with business leaders and...  ...with development, collaboration, and testing tools (e.g., JIRA, Git, SVN, etc.) Exposure to Logistics Systems and/or...