About Us CarePoint Health is one of New Jersey’s leading health care systems comprised of three long-standing and highly-regarded hospitals – Bayonne Medical Center, Christ Hospital, and Hoboken University Medical Center. CarePoint united these three area hospitals to provide 360 degree coordinated care by integrating the medical facilities and physician networks associated with these institutions. With over 4,500 employees, CarePoint is the largest private employer in Hudson County, New Jersey, and each year provides care to over 300,000 individuals. CarePoint prides itself on its patient-focused approach to care delivery, with an emphasis on preventative medicine, health education, and disease management. Leveraging its vast network of physicians and healthcare experts, CarePoint is quickly becoming recognized as a leader in the broader healthcare landscape as it pioneers creative solutions to address urgent population health needs. What You'll Be Doing The successful candidate will be able to: Under the supervision of the MSO Manager of the area, responsible for credentialing and recredentialing practitioners as well as enrollment with participating client health plans. Credentialing functions include, but are not limited to, processing credentialing applications, following up with payers, and updating and maintaining the CAQH data base. As well as following applicable state and federal requirements for Medicare and Medicaid. Leads, coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility. Conducts thorough background investigation, research and primary source verification of all components of the application file. Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up. Prepares credentials file for completion other healthcare organizations, ensuring file completion within time periods specified. Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing issues as they arise. Utilizes the Cactus credentialing database, optimizing efficiency, and performs query, report and document generation; submits and retrieves National Practitioner Database reports in accordance with Health Care Quality Improvement Act. Monitors the initial, reappointment and expirable process for all medical staff, Allied Health Professional staff, Other Health Professional staff, and delegated providers, ensuring compliance with regulatory bodies (Joint Commission, NCQA, URAC, CMS, federal and state), as well as Medical Staff Bylaws, Rules and Regulations, policies and procedures, and delegated contracts. Performs miscellaneous job-related duties as assigned.