Credentialing Operations Manager (Dental)
About The Position
Premier Care Dental Management is a growing dental practice management company that supports multi-state dental offices providing general dentistry and specialty services to children and adults. The Credentialing Operations Manager will report to the Vice President of Payor Relations and oversees credentialing, delegated credentialing, provider enrollment, payer participation, and scalable processes that support continued growth. This role partners with the Vice President of Payor Relations to expand delegated credentialing programs and infrastructure, while working with Revenue Cycle, Human Resources, Operations, and other teams to support provider readiness. This role is ideal for an experienced dental credentialing professional who thrives in a fast-paced environment, solves operational challenges, and builds efficient, scalable processes.
Requirements
- Minimum of 4–5 years of credentialing and provider enrollment experience within a Dental Service Organization (DSO) or other multi-location dental organization.
- Demonstrated experience working within a delegated credentialing environment.
- Strong knowledge of provider enrollment, recredentialing, CAQH, NPPES, commercial dental payer credentialing, and provider data management.
- Demonstrated leadership experience managing credentialing operations and supporting high-performing teams.
- Highly organized with exceptional attention to detail.
- Excellent written and verbal communication skills.
- Proven ability to work independently while managing multiple competing priorities.
- Demonstrated success working in a fully remote environment.
Nice To Haves
- Microsoft 365
- DocHub
- Asana
- DentalxChange
- Power BI
- Dental EMR (Denticon a plus!)
- smartsheet or other automated tracking systems
Responsibilities
- Lead, coach, and develop a team of credentialing and provider enrollment specialists.
- Oversee initial credentialing, recredentialing, provider enrollment, revalidation, and demographic maintenance for providers and locations.
- Partner closely with the Vice President of Payor Relations to help build and expand Dental365's delegated credentialing program, operational infrastructure, and broader strategic initiatives.
- Develop, document, implement, and continuously improve credentialing workflows, standard operating procedures, and operational best practices.
- Monitor key performance indicators, identify operational bottlenecks, recurring payer issues, and opportunities for automation and process improvement.
- Perform routine quality audits of credentialing files, enrollment records, delegated credentialing documentation, and operational processes to ensure ongoing compliance and audit readiness.
- Lead the operational implementation and ongoing administration of delegated credentialing programs with contracted payers.
- Ensure credentialing and recredentialing activities comply with delegation agreements, payer policies, applicable regulatory standards, accreditation requirements, and internal policies.
- Maintain complete and compliant credentialing files, committee documentation, policies, procedures, reports, and quality assurance records.
- Serve as the primary operational escalation point for provider enrollment, payer participation, and credentialing issues.
- Lead credentialing activities associated with provider onboarding, new office openings, acquisitions, mergers, provider transitions, and market expansion.
- Maintain operational dashboards and reports related to application status, aging, provider readiness, recredentialing, expirables, audit compliance, and staff productivity. Partner with Business Intelligence and other internal teams to identify reporting enhancements that support operational decision-making.
- Collaborate with Revenue Cycle Management, Integrations, Finance, Business Intelligence, Information Technology, Talent Acquisition, and other cross-functional departments to support provider readiness, delegated credentialing initiatives, and organizational growth.
Benefits
- Flexible Health and Vision Insurance Plans
- 401(K) Retirement Plan with Matching
- Generous Paid-Time Off (up to 3 weeks)
- Annual 'you' day for self-care
- Exclusive In-house Dental Program (Heavily discounted services for you and your immediate family)
- Extra Perks and Fringe Benefits
- Opportunity for massive growth
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
