Top 18 Lead director, credentialing operations Jobs in Franklin, Tn

Lead Director, Credentialing Operations
CVS Health —Nashville, TN
- $100,000 - $231,540 a year
- Full-time
- 7 years
- Inventory management
- Databases
- Health insurance
- Dental insurance
11h
Senior Project Lead Field Director
IQVIA —Nashville, TN
- $200,000 - $240,000 a year
- Full-time
- Remote
- 3 years
- Bachelor's degree
- Travel
- Work from home
9d
Lead Director, Stop Loss Relationship Management
CVS Health —Nashville, TN
- $100,000 - $231,540 a year
- Full-time
- Bachelor's degree
- Fair chance
- Experience equivalent to degree accepted
- Health insurance
- Dental insurance
3d
Credentialing Specialist
One Federal Solution —Franklin, TN
- Customer service
- Mid-level
- Administrative experience
Quick Apply
9d
Lead Director, Software Engineering
CVS Health —Nashville, TN
- $144,200 - $288,400 a year
- Full-time
- Computer Science
- System design
- HIPAA
- Health insurance
- Dental insurance
Lead Director - Software Development Engineering
CVS Health —Nashville, TN
- $144,200 - $288,400 a year
- Full-time
- Research
- High school diploma or GED
- Bachelor's degree
- Health insurance
- Dental insurance
Network Ops Coordinator II
CareAllies —Nashville, TN
- $47,500 - $86,000 a year
- Full-time
- Hybrid work
- Customer service
- Research
- Mid-level
- Paid parental leave
- Paid holidays
Lead Director, Actuarial Cred – Medicaid
CVS Health —Nashville, TN
- $144,200 - $288,400 a year
- Full-time
- 6 years
- Bachelor's degree
- Fair chance
- Health insurance
- Dental insurance
2d
Service Account Lead Associate Director - Residential Offering Lead
Accenture —Nashville, TN
- $150,900 - $413,600 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Residential
- Paid holidays
- Disability insurance
Administrative Assistant - Provider Credentialing & Medical Office Administration
Cardiovascular Anesthesiologists, P.C. —Nashville, TN
- $25 - $30 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Medical office experience
- Health savings account
- Disability insurance
Quick Apply
9d
Lead Event Technical Director
Tennessee Performing Arts Center Management Corp —Nashville, TN
- Weekends as needed
- Carpentry
- Bilingual
- CPR Certification
Quick Apply
Global Operate Technology Advanced AI Leader - Director
Deloitte —Nashville, TN
- Microsoft Word
- 11+ years
- Analysis skills
2d
Credentialing Specialist
Chord Specialty Dental Partners —Nashville, TN
- From $28 an hour
- Full-time
- Mid-level
- Organizational skills
- 1 year
- Paid holidays
- Disability insurance
Quick Apply
10d
Senior Credentialing Specialist
Chord Specialty Dental Partners —Nashville, TN
- $30 - $35 an hour
- Full-time
- Mid-level
- 3 years
- Organizational skills
- Paid holidays
- Disability insurance
Quick Apply
Regional Director / Office Leader - Architecture & Design
Ware Malcomb —Nashville, TN
- Full-time
- 11+ years
- Office
- Bachelor's degree
Quick Apply

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Lead Director, Credentialing Operations

CVS Health -
Nashville, TN

Apply Now

Job Details

Full-time
$100,000 - $231,540 a year
11 hours ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Inventory management
Change management
Data interpretation
Business operations
Cross-functional collaboration
Healthcare software applications

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.

Position Summary
The Lead Director, Credentialing Operations oversees the Credentialing Verification Organization (CVO) and is accountable for the overall delivery of credentialing services including production, quality audit, reporting, ongoing monitoring and process improvement for the business operation. Maintain and validate the credentialing data for all network providers for multiple lines of business. Ensure all provider information is accurately recorded and maintained to provide a compliant and quality network of providers who are treating Aetna members. Aligns policies and procedures for the Credentialing Operations department with organizational goals. Delivers on financial, operational, and service requirements while providing leadership and direction through multiple managers and vendors, by developing priorities and setting direction.

Key Responsibilities

Oversee operational management of Commercial, Medicare, Medicaid credentialing operations, as well as ongoing monitoring of all providers.
Manage a team of ~100 employees through multiple managers.
Oversee on-shore and off-shore vendor support tied to business operations to align resources to support inventory management and provide oversight of partner performance through quality and timeliness initiatives.
Contribute to planning and administration of company programs and initiatives that promote the Credentialing Operations agenda.
Accountable for department initiatives and objectives in partnership with stakeholders and leadership.
Implement organizational policies, goals, and objectives based on best practices in the field.
Build and develop strong functional operations management team through formal training, diverse assignments, coaching, communication, mentoring and performance management, and mentor team members to foster talent strategy and succession planning.
Cultivate and manage relationships with various internal business partners.
Ensure all Credentialing policies and procedures are executed consistently across the business operation and support alignment with accreditation agencies and regulatory bodies.
Administer audit procedures for maintaining accurate and compliant provider credentialing data for contractual compliance, and network directory listing purposes.
Experience with exploring solutions with automation, bots, AI, and other tools to drive exceptional performance in a highly visible operational environment.
Create and deliver process improvement strategies to address internal trends and meet organizational vision and commitments on an ongoing basis.
Drive change management through the organization to support competitive and changing environment.
Lead integration and administration of credentialing databases, software, and other data sources and create strategies for continuous improvement.
Control resources to deliver financial results and objectives within established budget parameters.

Required Qualifications

7+ years directly related experience in Healthcare Operations with a production focus
Adept at execution and delivery (planning, delivering, and supporting) skills
Advance working knowledge of business systems, applications, and tools supporting credentialing, provider data and inventory management.
Proven ability to work collaboratively at all levels.
Ability to effect change.
Exercises sound judgment and demonstrates analytical/data-driven decision-making skills.

Preferred Qualifications

Experience in a matrixed environment which includes outsourcing to external vendors.
Project management experience.

Education

Bachelor's degree or equivalent work experience

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

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: 08/15/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

lead director, credentialing operations jobs in franklin, tn

Lead Director, Credentialing Operations

Senior Project Lead Field Director

Lead Director, Stop Loss Relationship Management

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Lead Director, Software Engineering

Lead Director - Software Development Engineering

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Lead Director, Actuarial Cred – Medicaid

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