Credentialing Team Lead - Medical Staff Services

• Associate’s Degree Business Administration or related field. 
• Associates degree with five (5) years of experience OR Bachelors degree with three (3) years of experience.

Skills and Abilities:

• In-depth knowledge of medical staff services, credentialing processes, and compliance with regulatory and accreditation standards. 
• Ability to supervise, assign work, and evaluate team performance while fostering collaboration and professional development. 
• Understanding of Medical Staff Bylaws, Rules and Regulations, and external agency requirements. 
• Skilled in designing and maintaining auditing systems to ensure accuracy and efficiency in credentialing operations. 
• Strong verbal and written communication skills for interacting with physicians, medical staff leadership, and hospital administration. 
• Competence in Microsoft Office Suite and credentialing software for documentation, reporting, and meeting preparation.

The Credentialing Team Lead provides leadership and oversight for the credentialing team under the supervision of the Manager of Medical Staff Services. This role ensures compliance with Medical Staff Bylaws, Rules and Regulations, and regulatory standards by auditing credentialing processes, monitoring quality metrics, and maintaining accurate documentation. Responsibilities include assigning work, supporting training, preparing agendas for credentialing meetings, and serving as a liaison between the Credentials Verification Organization (CVO) and Medical Staff Office(s). The Team Leader plays a key role in facilitating timely and accurate credentialing and privileging activities while promoting efficiency and adherence to established policies.

Essential Functions:

• Supervise and support the credentialing team, assigning work and monitoring performance.
• Assignment of files & tracking of thresholds for the credentialing team.
• Audit credentialing files and processes to ensure accuracy, timeliness, and compliance with internal and external standards.
• Develop and maintain tracking systems for audits and quality metrics.
• Prepare agendas and facilitate credentialing-related committee meetings, ensuring accurate documentation of proceedings.
• Serve as a liaison between medical staff leadership, the Credentials Verification Organization (CVO) and Medical Staff Office(s), providing consultative expertise.
• Assist in developing and implementing policies and procedures for credentialing and privileging.
• Provide training and guidance to team members to ensure adherence to best practices.
• Maintain confidentiality of sensitive medical staff information and enforce compliance with bylaws and regulations.
• Collaborate with department chiefs and section leaders to resolve credentialing issues and ensure timely processing.
• Prepare reports and communicate audit results and performance metrics to leadership.