Lead Medical Staff Credentialing & Privileging

Atlantic Health; Pequannock Township (NJ); On-site; USD 80,000 - 100,000; Full time

Job summary

Atlantic Health is seeking a Credentialing & Privileging professional to determine practitioner eligibility for Medical Staff membership and clinical privileges. The role manages comprehensive credentialing, privileging and primary source verification with advanced analysis and independent judgment to uphold patient safety and regulatory compliance.

Responsibilities include oversight of workflows aligned with Joint Commission, CMS and NCQA standards, ensuring timely and accurate documentation,

Qualifications

• Experience in credentialing, privileging and primary source verification.
• Familiarity with Joint Commission, CMS and NCQA standards.
• Ability to interpret bylaws, policies and credentialing requirements.
• Proven ability to communicate with physicians and staff.

Responsibilities

• Conduct comprehensive initial and recredentialing primary source verification of education, training, licensure, work history and affiliations.
• Identify and resolve discrepancies or adverse findings to support informed leadership decisions.
• Process clinical privilege requests per established criteria.
• Monitor file progression through review, approval and audit-ready status.
• Communicate application status to stakeholders and respond to verification inquiries.
• Contribute to productivity, quality metrics and process-improvement initiatives.

Skills

Credentialing expertise

Primary source verification

Regulatory compliance

Stakeholder communication

Process improvement

Job description

Atlantic Health is seeking a Credentialing & Privileging professional to determine practitioner eligibility for Medical Staff membership and clinical privileges. The role manages comprehensive credentialing, privileging and primary source verification with advanced analysis and independent judgment to uphold patient safety and regulatory compliance.

Responsibilities include oversight of workflows aligned with Joint Commission, CMS and NCQA standards, ensuring timely and accurate documentation,