CVO & Credentialing Specialist – Delegated Credentialing

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, Credential Stream)

• 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.