Supervisor, Credentialing and Regulatory Operations

Role Overview

• Lead and develop multiple operational teams responsible for dental provider credentialing, recredentialing, and state‑specific provider directory verification activities.
• Ensure team compliance with all applicable state, regulatory, and accreditation requirements, including Medicare Advantage‑specific standards.
• Maintain oversight of team workloads and case progression to ensure provider applications and verifications move through the process within reasonable turnaround times and established service‑level agreements.
• Drive consistent execution of credentialing and recredentialing cycles, ensuring quality, accuracy, and regulatory adherence across all files.
• Oversee provider verification activities, including outreach to dental offices to confirm demographic, practice, and directory information in support of state‑specific requirements.
• Coordinate regulatory‑driven outreach across credentialing, recredentialing, and provider verification processes to reduce provider burden, eliminate duplication, and leverage shared information (e.g., provider location changes).
• Partner with technology and operations leaders to identify opportunities for automation and digital enablement, including ongoing evaluation of agentic AI and other tools to improve efficiency, quality, and scalability.
• Serve as a key operational leader supporting continuous improvement, process optimization, and change management initiatives.
• Lead with a customer mindset, ensuring professional, coordinated, and consistent provider communications across teams.

Requirements

• Credentialing experience, with a strong understanding of regulatory and operational requirements specific to provider networks
• Experience with Medicare Advantage credentialing requirements is preferred
• Proven people leadership experience managing operational teams in regulated healthcare, insurance, or provider network environments
• Deep knowledge and subject matter expertise of dental provider credentialing
• A strong process and system orientation, with the ability to balance compliance, quality, productivity, and customer experience
• Demonstrated ability to oversee complex, multi‑team workflows while driving accountability and performance outcomes
• Experience partnering with technology and transformation teams to identify and implement automation or digital solutions
• Strong critical thinking and judgment, with the ability to assess risk, identify dependencies, and make informed decisions
• Clear, confident communication skills and the ability to influence across operational, compliance, and leadership stakeholders
• A continuous‑improvement mindset and a track record of leading teams through change.

Benefits

• Flexible work arrangements
• Professional development opportunities
• Annual, sales, or other incentive compensation
• Support and flexibility to achieve professional and personal goals