Back

Supervisor, Credentialing and Regulatory Operations

Worldwide Salaried Open

About the position The 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.

Responsibilities

  • 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.
  • 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.

Nice-to-haves

  • Experience with Medicare Advantage credentialing requirements is preferred.

Benefits

  • 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.
  • 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 www.guardianlife.com/careers/corporate/benefits.

Apply tot his job Apply To this Job

More jobs

Credentialing Specialist

Worldwide Salaried

[Hiring] Provider Credentialing & Enrollment Specialist @PM Pediatric Care

Worldwide Salaried

[Hiring] Sr. Specialist, Credentialing @Oscar Health

Worldwide Salaried

[Hiring] Compliance & Credentialing Specialist @Ansible Government Solutions

Worldwide Salaried

[Hiring] Credentialing & Enrollment Lead @Mira Mace

Worldwide Salaried

[Hiring] Supervisor, Credentialing, Licensing, & Privileging @Radiology Partners

Worldwide Salaried

[Hiring] Supervisor, Provider Enrollment & Credentialing @Omega

Worldwide Salaried

[Hiring] Credentialing, Enrollment and Licensing Specialist @Imagine Pediatrics

Worldwide Salaried

[Hiring] Credentialing Coordinator I @Geisinger

Worldwide Salaried

[Hiring] Lead Licensing & Credentialing Coordinator @Rural Physicians Group

Worldwide Salaried

Experienced Customer Service Associate – Delivering Exceptional Experiences at arenaflex

Worldwide Salaried

Software Engineer, iOS Core Product - Huntsville, AL, USA

Worldwide Salaried

Account Manager, Fully Insured *Hybrid*

Worldwide Salaried

Experienced TikTok Data Entry Specialist – Remote Part-Time & Flexible Hours

Worldwide Salaried

Commercial Lines Senior Client Manager

Worldwide Salaried

Sales Manager

Worldwide Salaried

Data Engineer Senior - Microsoft Fabric

Worldwide Salaried

Experienced Customer Service Representative – Part-Time Remote Support Specialist

Worldwide Salaried

Data Implementation Manager, Life Sciences

Worldwide Salaried

Senior Scheduler - Data Centers (Traveling)

Worldwide Salaried