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.
