Credentialing Lead

Essen Medical Associates•Bronx, NY

About The Position

At Essen Health Care, we care for that! As the largest privately held multispecialty medical group in the Bronx, we provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a Population Health model of care, Essen has five integrated clinical divisions offering urgent care, primary care, and specialty services, as well as nursing home staffing and care management. Founded in 1999, our over 20-year commitment has fueled an unwavering dedication toward innovating a better healthcare delivery system. Essen has expanded from a single primary care office to an umbrella organization offering specialties from women’s health to endocrinology, from psychiatry to a vast array of other specialties. All clinical services are offered via telehealth or in-person at over 35 medical offices and at home through the Essen House Calls program. Essen Health Care is the place Where Care Comes Together! We are looking for the most talented and effective individuals to join our rapidly growing company. With over 1,100 employees and 400+ Practitioners, we care for over 250,000 patients annually in New York City and beyond. From medical providers to administration & operational staff, there is a career here for you. Join our team today! Job Summary The Credentialing Lead is responsible for Credentialing Committee Preparation, overseeing the complete lifecycle of provider credentialing, including file review, verification, committee preparation, and ongoing monitoring. This role ensures compliance with NCQA, TJC, CMS, State regulations, organizational policies, and delegated credentialing requirements. The Supervisor leads staff, manages workflows, ensures quality, and supports timely onboarding and committee readiness.

Requirements

3–5 years of healthcare credentialing or medical staff services experience.
1–2 years of supervisory or team lead experience.
Strong knowledge of NCQA, TJC, CMS, and State regulatory standards.
Excellent attention to detail, organization, and ability to manage multiple priorities.
Strong communication skills and ability to work with executive and clinical leadership.

Nice To Haves

Certified Notary - New York State
CPCS or CPMSM certification (or willingness to obtain).
Experience with credentialing systems ( MD Staff, Medallion , Passport, MD Staff, Modio , etc. )

Responsibilities

Oversee preparation of credentialing packets for all meetings, ensuring accuracy, completeness, and regulatory alignment.
Present all files, terminations, meeting minutes, and new business items to the Credentialing Committee, ensuring materials are complete and compliant.
Manage agendas, meeting schedules, follow-ups, minutes, and voting documentation.
Collaborate with Medical Directors to finalize meeting materials, especially for red flagged providers.
Oversee all delegated credentialing compliance requirements, including coordination of annual audits and preparation of semi annual delegation reports, ensuring accuracy, timely submission, and adherence to regulatory and contractual standards.
Supervise the management of credentialing expirables , ensuring all licenses, certifications, and required documents are monitored, updated, and addressed in a timely and compliant manner.
Review all credentialing applications for completeness, log required information and request missing documentation.
Critically evaluate applications for discrepancies, red flags, or quality of care concerns and escalate when appropriate.
Perform comprehensive primary source verification (PSV) for licensure, DEA, board certification, NPDB, education/training, malpractice history, and other required elements.
Track and follow up on all outstanding verifications to ensure timely completion.
Oversee monthly monitoring activities (licensing boards, OPMC, OMIG, OIG/SAM, Medicare Opt Out) to ensure prompt identification and documentation of adverse actions.
Monitor the full credentialing lifecycle — initial appointment, reappointment, expirables , and ongoing monitoring — to ensure compliance with regulatory and delegated standards.
Ensure secure handling and confidentiality of all credentialing and committee materials.
Serve as a key liaison to Operations, People and Culture, and Malpractice D epartments, ensuring seamless information ‑ sharing, timely updates, onboarding coordination, and collaboration on provider readiness and risk ‑ related matters.
Supervise and mentor Credentialing staff ; monitor workload and performance standards.
Provide training on credentialing requirements, verification processes, and committee procedures.
Conduct file audits to ensure accuracy and quality.
Coordinate with onboarding staff, internal departments, and compliance teams to support provider readiness.
Prepare verification related payment requests.
Utilize credentialing databases to track status, outcomes, and follow up tasks; prepare reports and dashboards for leadership.