Credentialing Specialist

Village Care • New York, NY

6d • $58,040 - $65,294 • Hybrid

About The Position

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

As a Credentialing Specialist, you will help ensure the VillageCareMAX provider network meets NYS DOH, CMS, NCQA, and internal standards by coordinating credentialing and recredentialing activities and maintaining accurate, audit-ready records. You will manage assigned cases end-to-end, partnering with the Credentials Verification Organization (CVO) and internal stakeholders to resolve discrepancies and keep files complete.

Requirements

• Strong Excel skills (formulas, pivot tables, filtering, tracking)
• High attention to detail, organization, and follow-through

Nice To Haves

• 1-3 years in healthcare credentialing/enrollment/provider data or managed care operations
• Bachelor's degree
• NAMSS or related credentialing training

Responsibilities

• Coordinate credentialing and recredentialing activities.
• Maintain accurate, audit-ready records.
• Manage assigned cases end-to-end.
• Partner with the Credentials Verification Organization (CVO) and internal stakeholders to resolve discrepancies and keep files complete.
• Perform credentialing for organizational and institutional providers.
• Review submissions for completeness and accuracy.
• Track case status and document actions.
• Draft provider status correspondence.
• Prepare Credentialing Committee agendas and compliance reports.
• Complete sanction/exclusion and Medicare opt-out checks.
• Support PSV for internal clinical staff.
• Assist with delegation oversight audits and related documentation.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level