Credentialing Supervisor

Essen Medical Associates•New York, 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 Supervisor is responsible for overseeing the day-to-day operations of the payor enrollment function, ensuring accurate, timely, and compliant enrollment of clinical providers, including Primary Care Providers, Specialists, and Ancillary Providers. This role provides direct supervision to credentialing staff, manages complex and escalated enrollment cases, and ensures all processes adhere to federal, state, and payor regulatory requirements.

Requirements

Proven experience in provider credentialing and payer enrollment, preferably in a supervisory or lead role.
Knowledge of CAQH, PECOS, state Medicaid systems, and commercial payer requirements.
Strong leadership, organizational, and problem-solving skills.
Excellent communication skills, with the ability to collaborate across departments.
Detail-oriented, proactive, and able to manage multiple priorities and deadlines.
High School Diploma Required
Minimum of at least 3 years in a medical credentialing / enrollment role. 1 year as supervisor.
Strong interpersonal and communication skills with an ability to work effectively with a wide range of people, teams, managers, supervisors, and vendors.
Proficient with MS Office (outlook, word, excel, power point, access)
Excellent organizational and time-management skills.
Excellent verbal and written communication skills.
Ability to analyze, interprets and draws inferences from research findings, and prepares reports.
Working knowledge of clinical operations and procedures.
Informational research skills.
Ability to use independent judgment to manage and impart confidential information.
Database management skills including querying, reporting, and document generation.
Ability to make administrative/procedural decisions and judgments

Nice To Haves

Bachelor’s Degree in a Health-Related Discipline: Public Health, Healthcare Administrative, Health Service, Psychology or Sociology Highly Preferred
Certified Provider Credentialing Specialist (CPCS), Certified Professional Medical Services Management (CPMSM) or Certified Provider Enrollment Specialist (CPES) a plus
Experience in a multi-specialty medical group or large healthcare organization
Process improvement or workflow optimization experience

Responsibilities

Comply with Credentialing Policy and Procedures, Departmental Guidelines and Company Policy
Supervise and support the credentialing team in day-to-day operations, providing guidance, training, and performance feedback.
Manage offshore credentialing teams, ensuring quality, productivity, and workflow consistency.
Ensure compliance with regulatory and payor-specific standards (e.g., NCQA & CMS).
Oversee end-to-end payer enrollment processes, including Medicare (PECOS, I&A), Medicaid, commercial plans, via direct enrollment applications and delegated rosters across multiple states, including NY, TX, OH, PA, MA, NE, and NJ, in compliance with state-specific requirements.
Support facility credentialing efforts, including Civil Surgeon designation, Workers’ Compensation, CAQH profile maintenance, hospital affiliations, and accreditation documentation.
Track credentialing pipelines, monitor turnaround times, and escalate complex or delayed issues as needed.
Conduct payer enrollment gap reviews to identify and resolve lapses or delays in participation.
Monitor credentialing pipelines, ensure SLAs are met, and resolve escalated or complex issues.
Maintain comprehensive documentation and reporting for audits, regulatory compliance, and leadership updates.
Implement process improvements to enhance efficiency, accuracy, and compliance within the credentialing function.
Complete other tasks or projects assigned
Provide back-up to other Credentialing staff as necessary