Medical Staff Services & Credentialing Supervisor

AtlantiCare•Atlantic City, NJ

6d•Onsite

About The Position

The Supervisor, Medical Staff Services & Credentialing, is responsible for the day-to-day operational supervision, oversight, and performance management of the Medical Staff Office credentialing team and administrative support functions. This role ensures that all medical staff credentialing, privileging, reappointment, and related Medical Staff processes are executed in full compliance with The Joint Commission (TJC), CMS, Medicaid, NCQA, Medical Staff Bylaws, and organizational policies. In addition, the Supervisor serves as a key operational partner to the Senior Director of Physician Services and the Delegation Analyst to ensure alignment, accountability, and consistency across credentialing and delegated credentialing functions. While the Supervisor does not own delegation work as a primary responsibility, they are expected to collaborate, escalate issues, support operational problem-solving, and provide leadership coverage as needed, including stepping in alongside the Senior Director when required to support continuity of operations. This role functions as a representative of the Medical Staff Office in internal and external interactions and serves as the final internal operational review for credentialing and privileging items prior to presentation to the Credentials Committee, Medical Executive Committee (MEC), and other governing bodies.

Requirements

Bachelor’s degree or equivalent combination of education and experience preferred.
Progressive experience in medical staff credentialing or provider enrollment.
Prior supervisory or lead experience strongly preferred.
Demonstrated working knowledge of: Medical Staff Bylaws and governance Credentialing and privileging standards TJC, CMS, Medicaid, and NCQA requirements
Experience using credentialing systems (MSOW and/or MD-Staff preferred).

Nice To Haves

Experience supporting delegated credentialing or NCQA accreditation.
Experience in a multi-hospital or complex health system environment.

Responsibilities

Medical Staff Credentialing & Privileging Oversight
Provide direct supervision and operational leadership to Credentialing Specialists and Administrative Secretary.
Ensure timely, accurate, and compliant processing of: Initial appointments Reappointments Privilege requests and modifications Resignations, leaves of absence, suspensions, and reinstatements
Confirm adherence to: Medical Staff Bylaws, Rules & Regulations, and policies Credentialing and privileging criteria Regulatory and accreditation standards (TJC, CMS, Medicaid, NCQA)
Serve as the final internal operational review prior to submission to: Credentials Committee Medical Executive Committee (MEC) Governing Board, as applicable
Delegated Credentialing Collaboration & Oversight
Collaborate closely with the Delegation Analyst and Senior Director to ensure: Credentialing Specialists understand and meet expectations related to delegated credentialing workflows. Credentialing processes align with NCQA delegated credentialing requirements and payor expectations.
Serve as an escalation and coordination point when issues arise that impact credentialing accuracy, timeliness, or delegation readiness.
Support cross-functional problem-solving related to: Data integrity File completeness Audit findings Process gaps affecting delegation
Maintain flexibility to assist or step in alongside the Senior Director as needed to support delegation-related initiatives or operational continuity.
Supervisory & Leadership Responsibilities
Assign, prioritize, and monitor daily and long-term work assignments for credentialing staff.
Conduct ongoing performance coaching, feedback, and corrective guidance in collaboration with the Senior Director.
Participate in performance evaluations and staff development planning.
Approve staff PTO requests in coordination with the Senior Director; ensure appropriate coverage and continuity of operations.
Monitor workload distribution and proactively identify staffing or workflow concerns.
Ensure staff compliance with departmental standards, timelines, and expectations.
Serve as a role model for professionalism, accountability, and regulatory rigor.
Committee & Governance Support
Ensure credentialing and privileging materials are: Accurate Complete Properly vetted Submitted in accordance with established deadlines
Support preparation of agendas, supporting documentation, and follow-up actions for: Credentials Committee Medical Executive Committee (MEC) Other Medical Staff or governance committees as assigned
Track and ensure timely execution of committee decisions and follow-up actions.
Systems, Data Integrity & Reporting
Oversee accurate data entry and maintenance within MSOW (current system).
Play a key operational role in the transition from MSOW to MD-Staff, including: Staff readiness Workflow alignment Data accuracy and consistency
Ensure credentialing data integrity to support: Master Roster development Regulatory reporting Payor and delegated credentialing requirements
Identify trends, risks, and process gaps and escalate concerns to the Senior Director.
Regulatory, Accreditation & Survey Readiness
Maintain continuous readiness for: TJC surveys CMS and Medicaid reviews NCQA accreditation and delegated credentialing audits
Ensure documentation, files, and workflows meet surveyor expectations.
Participate in surveys, audits, and site visits as required, including travel between campuses or other locations.
Representation & Professional Collaboration
Represent the Medical Staff Office in meetings with: Physicians and APPs Department Chairs and Medical Staff leadership Quality, HR, IT, Compliance, and other departments
Communicate professionally and effectively with internal and external stakeholders.
Escalate sensitive or high-risk issues to the Senior Director in a timely manner.
Decision-Making Authority
Authorized to make day-to-day operational decisions related to credentialing workflow, staff assignments, and issue resolution.
May approve PTO in coordination with the Senior Director.
May represent the Medical Staff Office operationally in meetings and discussions.
Does not independently alter Medical Staff policy, bylaws, or credentialing criteria without Senior Director approval.

Benefits

Generous Paid Time Off (PTO)
Medical, Prescription Drug, Dental & Vision Insurance
Retirement Plans with employer contributions
Short-Term & Long-Term Disability Coverage
Life & Accidental Death & Dismemberment Insurance
Tuition Reimbursement to support your educational goals
Flexible Spending Accounts (FSAs) for healthcare and dependent care
Wellness Programs to help you thrive
Voluntary Benefits, including Pet Insurance and more
Benefits offerings may vary based on position and are subject to eligibility requirements.