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

R3ZQUG1hTnhHY1d3ZS9RS3FnbTZ6aUhETXc9PQ==
  • 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

Kamehameha Schools

Summer Instructor, Elementary School Job at Kamehameha Schools

 ...you join our ohana! Kamehameha Schools provides meaningful educational opportunities for Native Hawaiian learners to explore their potential...  ...~(FILLED) Generalist Upper Elementary (FILLED) Outdoor Education (FILLED) Technology (FILLED) Math & English... 

MAHLER PRIVATE STAFFING

Nanny Job at MAHLER PRIVATE STAFFING

Full-Time Nanny A warm, respectful family located in the Magnificent Mile area is seeking a proactive and nurturing full-time nanny to...  ...Proactive, organized, and able to manage the day independently Able to travel with family CPR/First Aid certified (or willing to obtain) Bonus... 

CROSSWINDS AVIATION

Certified Flight Instrument Instructor Job at CROSSWINDS AVIATION

 ...Provide flight, simulator, and ground instruction in accordance with Part 61 and 141, FAA regulations, Airmens Information Manual, advisory circulars, airport operations, and Crosswinds Aviation policies and procedures. Schedule students, maintain records, and ensure... 

Veta Virtual

Customer Service Representative Job at Veta Virtual

 ...for You: Join Our Dynamic Team at Veta Virtual! Are you a vibrant and energetic...  ...a passion for delivering exceptional customer experiences? Do you thrive in managing...  ...passion. Your Role: As a Customer Service Representative at Veta Virtual, you will be the friendly... 

Burger King

Assistant Restaurant Manager Job at Burger King

 ...first is at the core of our company culture. Come be a part of our all-star team! Every day, more than 11 million guests visit BURGER KING restaurants around the world. And they do so because our restaurants are known for serving high-quality, great-tasting, and...