Credentialing Specialist

Position: Credentialing Specialist

Location: Hybrid (Must Reside in NY/NJ/CT)

Work Schedule: Monday - Friday, 9:00am - 5:00pm

Compensation: $58,039.56 - $65,294.40 Annually

Our Purpose

VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services.

Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Role Summary

As a Credentialing Specialist, you will help ensure the VillageCareMAX provider network meets NYS DOH, CMS, NCQA, and internal standards by coordinating credentialing and recredentialing activities and maintaining accurate, audit-ready records. You will manage assigned cases end-to-end, partnering with the Credentials Verification Organization (CVO) and internal stakeholders to resolve discrepancies and keep files complete.

Key responsibilities include credentialing for organizational and institutional providers; reviewing submissions for completeness and accuracy; tracking case status and documenting actions; drafting provider status correspondence; preparing Credentialing Committee agendas and compliance reports; completing sanction/exclusion and Medicare opt-out checks; supporting PSV for internal clinical staff; and assisting with delegation oversight audits and related documentation.

Qualifications:
- 1-3 years in healthcare credentialing/enrollment/provider data or managed care operations (preferred)
- Strong Excel skills (formulas, pivot tables, filtering, tracking)
- High attention to detail, organization, and follow-through
- Bachelor's degree preferred; NAMSS or related credentialing training a plus

If you're ready to contribute to a compliant, high-quality network, apply today.

A Typical Workday

Your day is structured around a Monday-Friday, 9:00am-5:00pm schedule with work-from-home flexibility, balancing independent focus time with timely coordination. You'll start by checking queues and dashboards, then align priorities with the Manager of Contract Execution and Provider Onboarding. Throughout the day, you'll move between your credentialing platform, Excel trackers, and shared folders to keep records current and easy to retrieve.

You'll dedicate blocks of time to follow-ups and status updates, ensuring communications are clear, properly documented, and ready for review. As meetings or committee deadlines approach, you'll shift into preparation mode-organizing materials and confirming that supporting documentation is in place. You'll also respond to audit or oversight requests as they arise, keeping work consistent, traceable, and compliant.