Director, Credentialing and Provider Enrollment

The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S. and has supported over 20,000 healthcare professionals and team members at more than 1,300 health and wellness offices across 48 states in four distinct categories: dental care, urgent care, medical aesthetics, and animal health. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Chapter Aesthetic Studio, and AZPetVet. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale. As a reflection of our continued growth, we have an exciting opportunity to join our team as Director- Credentialing Enrollment.

The Director- Credentialing Enrollment will lead a large team and drive strategies for the team. This role is responsible for determining appropriate and effective performance metrics and staff requirements to run with efficiency, accuracy, and outstanding customer service; manages to metrics. This role reports to the SVP of Payor Strategy.

Specific Responsibilities:

• Oversee the Aspen Dental Credentialing Enrollment teams. This includes multiple organizational layers, overseeing approximately 20 employees.

• Daily oversight, audit functionality and responsibility for teams that perform all provider credentialing and dental plan enrollment (including delegated credentialing).  

• Maintain and report to leadership on team performance using metrics and KPIs, while continually looking for ways to improve efficiencies.

• Develops written Standard Operating Procedures for the centralization and standardization of the processes; continually monitors changes in workflow as needed to improve productivity. 

• Manage and/or assist in key department or cross-functional projects.

• Developing a strong sustainable team by attracting, developing, rewarding, and retaining talent.

• Monitors the effectiveness of team activities to ensure productivity is maximized within regulatory guidelines and assure continuing compliance. 

• Works directly with plans to foster a strong partnership and maximize efficiencies related to all credentialing enrollment functions.

• Motivates diverse teams by exemplifying the company vision, mission, values, and culture.

• Forecasts department staffing needs and manages staffing levels, with a strong focus on developing and retaining strong talent. Develops and manages the department financial budget.

• Works across the organization (field teams and practice support teams) to develop best-in-class practices that support best-in-class results.

Education and Background:

• Bachelor's degree required.

• 7 years’ experience with in-depth working knowledge of provider credentialing.

• Experience in a growing healthcare environment.

• Strong working knowledge of CAQH and NCQA guidelines, as well as industry standards for credentialing best practices.

• Proficient in navigating state regulations guidance on requirements.

• Strong working knowledge of the end-to-end credentialing process, including primary source verification, delegated credentialing and dental plan provider enrollment.

• Proven career progression with increasing levels of project experience and responsibility.

• Proficient in Microsoft Office, including Excel, Word, and PowerPoint.

Characteristics and Abilities:

• Excellent oral and written communications, interpersonal and organizational skills.

• Strong ability to measure and report to key metrics of team performance.

• Multiple project leadership, business partnering and cross department/matrix collaboration.

• Self-management abilities and sound business judgment.

• High level of experience and expertise successfully managing a team.

• Flexibility to support and to adapt to change.

• This role requires current, in-depth knowledge of governmental and commercial insurance rules and regulations.

• Actively researches and remains apprised of industry/ regulatory trends and best practices.

Location: Syracuse, NY and Chicago, IL preferred, will consider remote candidates based on experience

Salary: 150-180k, plus bonus/incentives

• A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match