Manager, Credentialing Data Integrity Services - (Medical Staff Credentialing Office)
Atlantic Health System•Morristown, NJ
•Onsite
About The Position
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.
Requirements
- Medical Staff Credentialing Office experience
- Leadership and oversight experience
- Experience with credentialing data integrity operations
- Knowledge of regulatory compliance (TJC, CMS, DOH, NCQA)
- Experience with credentialing workflows, applications, reporting, and Provider Hub access
- Experience with data validation, reconciliation, and cleanup initiatives
- Experience with system integration and interoperability
- Experience with reporting and analytics for operations and decision-making
- Experience developing and maintaining policies and procedures
Nice To Haves
- Experience with CredentialStream
- Experience with Epic
- Experience with IT, Revenue Cycle, and related teams collaboration
- Experience with website content management
- Experience with budget adherence
Responsibilities
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Ensure adherence to budgetary guidelines for operational and project-related activities
- Perform other duties as assigned
Benefits
- Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
- Life & AD&D Insurance
- Short-Term and Long-Term Disability (with options to supplement)
- 403(b) Retirement Plan: Employer match, additional non-elective contribution
- PTO & Paid Sick Leave
- Tuition Assistance, Advancement & Academic Advising
- Parental, Adoption, Surrogacy Leave
- Backup and On-Site Childcare
- Well-Being Rewards
- Employee Assistance Program (EAP)
- Fertility Benefits, Healthy Pregnancy Program
- Flexible Spending & Commuter Accounts
- Pet, Home & Auto, Identity Theft and Legal Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
