Job DescriptionJob Description:Provides leadership and oversight of credentialing data integrity operations, ensuring reliable data, regulatory compliance, and streamlined processes that support efficient provider onboarding and ongoing performance management.
Principal Accountabilities:Leadership & Oversight- Provide direct oversight of the Credentialing Data Integrity team, including supervision, performance management, and workforce planning
- Establish team goals, monitor performance, and foster a culture of accountability and continuous improvement
- Manage staffing and resource allocation to ensure productivity and quality outcomes
- Develop training strategies and support professional development across Data Integrity roles
Operational Support & Training- Ensure support for system users across credentialing workflows, applications, reporting, and Provider Hub access
- Provide day-to-day operational support and assist users with Service Operations tickets related to:
- Applications
- Privilege requests
- Credentialing workflows
- Reporting
- Provider Hub access
- PDF forms, letters, and document upload issues
- System performance/vendor escalation tickets
- Data discrepancies (e.g. incorrect office addresses, fax and phone)
- Duplicate records
- Deliver end-user training and develop user guides and tools to support adoption and efficiency
- Translate technical system functionality into clear, user-friendly instructions
Data Governance & Integrity- Ensure the accuracy, consistency, and integrity of credentialing data within CredentialStream and across downstream systems (e.g., Epic, web directories)
- Lead data validation, reconciliation, and cleanup initiatives
- Maintain accountability for enterprise credentialing data standards and governance practices
- Resolve complex data discrepancies and serve as escalation point for data-related issues
Operations & Process Optimization- Lead the design, implementation, and optimization of credentialing workflows and data processes
- Identify inefficiencies and implement automation and standardization strategies
- Partner with credentialing teams to improve turnaround times and reduce manual work
- Oversee development and maintenance of forms, templates, and workflows
Systems & Reporting- Oversee department website content (internal and external) related to credentialing resources
- Oversee reporting and analytics to support operations, leadership decision-making, and audit readiness
- Develop dashboards and deliver routine and ad hoc reports on data integrity metrics
- Collaborate with IT, Epic, Revenue Cycle, and related teams to enhance system integration and interoperability
- Support system upgrades, enhancements, and issue resolution in partnership with vendors and IT
Regulatory Compliance & Audit Readiness- Ensure compliance with TJC, CMS, DOH, and NCQA standards
- Support audits by preparing documentation, reports, and credentialing file data
- Develop and maintain policies, procedures, and standard operating documentation
Collaboration & Stakeholder Engagement- Serve as a subject matter expert and primary liaison for credentialing data integrity
- Engage stakeholders across Medical Staff Services, IT, Risk Management, and operational teams
- Support organizational initiatives related to onboarding, credentialing optimization, and data transparency
Additional Responsibilities- Ensure adherence to budgetary guidelines for operational and project-related activities
- Perform other duties as assigned
QualificationsEducation/Experience:- Bachelor's degree in Data Analytics, Healthcare Administration, Computer Science required. Master's Degree Preferred
- 5 years of credentialing database or data management experience required.
- 2-4 years working with credentialing systems (e.g. CredentialStream, MDStaff) and EHRs (e.g., Epic)
- Experience in healthcare credentialing, privileging, or medical staff operations preferred
- 5 years of supervisory experience working in an organization of size and complexity comparable to Atlantic Health preferred.
About the TeamAtlantic Health System is at the forefront of medicine, setting standards for quality health care powered by a workforce of more than 18,000 team members and 4,800 affiliated physicians dedicated to building healthier communities, the system offers more than 400 sites of care, including eight award-winning medical centers. Specializing in cardiovascular care, cancer care, orthopedics, neuroscience, pediatrics, women's health and rehabilitation medicine. Atlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and includes finance, legal, marketing, human resources, talent acquisition, ISS and more. Caring for our patients, our team members and the communities we serve is our central mission.
