Supervisor, Credentialing and Regulatory Operations
$82.77k - $135.98kGuardian Life
- # Supervisor, Credentialing and Regulatory OperationsApplyremote type: Hybrid - In office 3 days per weeklocations: Boston: Bethlehem: New York: Holmdeltime type: Full timeposted on: Posted Yesterdayjob requisition id: R000108950The Supervisor, Credentialing & Regulatory Operations role is accountable for leading operational execution and regulatory compliance across dental provider credentialing, recredentialing, and state‐specific provider verification activities. This leader oversees multiple teams responsible for ensuring accurate, timely, and compliant provider onboarding and directory maintenance, with a strong focus on customer experience, operational excellence, and scalable execution.You will lead and develop teams of credentialing and verification professionals while partnering with compliance, operations, and technology stakeholders to ensure Guardian meets state‐specific regulatory requirements and service‐level expectations. Through disciplined workload oversight, process coordination, and thoughtful deployment of digital and automation capabilities, you will help drive sustainable, high‐quality outcomes that support Guardian’s dental growth strategy, including Medicare Advantage networks.**You Will:*** 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.* 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.**You Have:*** Credentialing experience, with a strong understanding of regulatory and operational requirements specific to provider networks.* 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.* Experience with Medicare Advantage credentialing requirements is preferred.* 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.**Location and Work Arrangement:*** The work arrangement for this position will be hybrid (three days per week in a local Guardian Office; two days per week working from home).* Preferred locations include Bethlehem, PA; Boston, MA; Holmdel, NJ, and New York, NY.* Occasional travel required**Salary Range:**$82,770.00 - $135,975.00The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.**Our Promise**At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.**Inspire Well-Being**As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at *Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.* **Equal Employment Opportunity** Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law. **Accommodations** Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact View email address on click.appcast.io. Please note: this resource is for accommodation requests only. For all other inquires related to your application and careers at Guardian, refer to the Guardian Careers site. **Visa Sponsorship** Guardian is not currently or in the foreseeable future sponsoring employment visas. In order to be a successful applicant. you must be legally authorized to work in the United States, without the need for employer sponsorship. **Notice Regarding Guardian’s Use of Artificial Intelligence in Recruitment** As part of Guardian’s job application process, Guardian may use artificial intelligence tools (“AI Tools") to automate the sorting and filtering of information provided by applicants as part of its preliminary screening. This preliminary screening may be used to help identify applicant materials and resumes relative to their indication that the applicant meets the requirements for the specific job for which they are applying, as specified in the listing posted on Guardian’s jobs website (Careers at Guardian at At Guardian, we do not use AI Tools to substantially assist or replace human judgment or discretionary decision making in our hiring process. All hiring decisions will be made by Guardian colleagues. Please be aware that if you apply for a specific position with Guardian, you will have the choice of opting out of Guardian’s use of AI Tools during the job application process. If you would like to request an alternative process that does not utilize AI Tools or would like to request a reasonable accommodation, within ten business days of your position application, you must email your request to View email address on click.appcast.io, making sure to provide your name and job requisition identification number. Guardian will retain your applicant materials and resume and all information therefrom in accordance with Guardian’s document retention policy, a copy of which you may request via View email address on click.appcast.io.
- J-18808-Ljbffr Guardian Life
Vacancy posted 2 days ago
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