| Location | Newton, NJ |
Position Summary:
Determines practitioner eligibility for Medical Staff and Allied Health Professional Staff membership and /or clinical privileges. Performs complex credentialing, privileging and primary source verification functions requiring advanced analytical skills, critical thinking, and independent judgment. Ensures the integrity, accuracy, and timeliness of credentialing information in compliance with regulatory and accreditation standards. Serves as a key resource to leadership, providers, and interdisciplinary stakeholders to support high-quality practitioner evaluation and patient safety.
Key Responsibilities:
Credentialing & Privileging Oversight:
Conducts comprehensive initial and recredentialing primary source verification of education, clinical training, licensure, work history, hospital/healthcare affiliations, malpractice claims history, peer references, and other elements as required per the bylaws and policies to ensure competency.
Identifies, investigates, and resolves discrepancies or adverse findings to support informed decision-making by medical staff leadership and committees.
Processes clinical privilege requests in alignment with established clinical/specialty criteria.
Regulatory Compliance & File Management:
Manages credentialing workflows to ensure compliance with Joint Commission, CMS, and NCQA standards, maintaining strict adherence to required timelines.
Monitors file progression through review and approval stages, ensuring completeness, accuracy, and audit readiness.
Stakeholder Engagement & Communication:
Serves as a liaison to physicians, advanced practice providers, and internal/external stakeholders to communicate application status, resolve issues, and obtain required documentation.
Provides guidance on medical staff bylaws, policies, and credentialing requirements, and responds to verification inquiries and organizational requests.
Performance & Continuous Improvement:
Independently manages productivity and quality metrics, ensuring high standards of accuracy and efficiency.
Contributes to process improvement initiatives, supports system optimization efforts, and participates in departmental and organizational projects.
At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:
We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.
We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:
Since 1932, Newton Medical Center has been providing care to the people of Sussex and warren counties in New Jersey, Pike County in Pennsylvania and southern Orange County in New York. We are home to the Center for Breast Health, the only one of its kind in Sussex County, addressing all of a woman's breast health needs with state-of-the-art technology, resources, education, support and follow-up care. Newton Medical Center recently achieved the American Nurses Credentialing Center's Pathway to Excellence designation and is one of a select few health care facilities in New Jersey accredited by the Intersocietal Accreditation Commission (IAC) in all three echocardiography procedures: adult transthoracic, adult transesophogeal and adult stress.
Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:
Team Member Benefits
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Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.
EEO STATEMENT
Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.
Education/Experience