Director, National Operations

Aspen Dental•IL - Remote, IL

7d•$160,000 - $175,000•Onsite

About The Position

The Aspen Group (TAG) is a leading retail healthcare business support organization in the U.S., supporting numerous healthcare professionals and offices across various categories like dental care, urgent care, medical aesthetics, and animal health. TAG partners with independent practice owners and clinicians, aiming to improve healthcare through centralized business support services for brands such as Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Chapter Aesthetic Studio, and Lovet Pet Health Care. This new opportunity for a Director of National Operations is within the Payor Strategy Team, reporting to the Vice President, Payor Strategy. The role involves managing national plan relationships and contract strategy for both the Aspen Dental and WellNow brands, overseeing a team of 2-4 employees.

Requirements

Bachelor's degree
Highly proactive, with strong critical thinking skills and the ability to architect solutions rather than just flag problems
Direct experience with insurance and provider contracting required. Must have been personally involved in managed care contracting or contract strategy work, not just adjacent to it
Strong exposure to healthcare operations required. Dental experience is not required; medical or other clinical operations experience is a fit
7 or more years of progressively responsible management or supervisory level managed care contracting experience in a payor or health care setting, with experience across multiple brands or business lines preferred
Broad knowledge of healthcare insurance, healthcare billing and reimbursement, administration, systems, practices and principles (i.e. Medicare, Medicare Advantage, and Commercial)
Knowledge and ability to effectively use negotiation techniques and practices to advocate for providers
Excellent verbal and written communication
Excellent time management, prioritization, and organizational skills
Detail oriented with a strong level of analytical and problem-solving skills
Proficient use of Microsoft Office Suite

Responsibilities

Develop and maintain effective working relationships with insurance company contacts for assigned national plans.
Oversee the entire operational relationship with assigned national plans across Aspen Dental and WellNow, including grievances, rate validation, educational outreach, and any other operational issue that affects the plan.
Proactively look for ways to improve support to Aspen offices, streamline processes with plans, and increase transparency and issue resolution for offices and owners.
Oversee and participate in Joint Operating Committees (JOCs) for assigned national plans, driving continued results with plan partners.
Ensure audits occur monthly for national plans to confirm accurate network information and drive quick resolution of contract data issues.
Identify trends across markets and partner with department heads to build educational resources for the plans.
Oversee the distribution of field education and company initiatives to the field as needed.
Act as an expert resource on escalated contractual and compliance issues for national plans.
Monitor contract performance and other provisions to assure compliance, identify problem areas, and resolve disputes.
Resolve escalated contract issues generated by operational department heads.
Work collaboratively with payors and Aspen Department Leadership (Legal/Compliance, Finance, Centralized Billing, and IT) on strategic business development efforts to ensure geographic reach, plan and service types, and optimal reimbursement rates.
Train, support, and develop the team to meet department metrics and expectations.
Ensure the team delivers first-class customer service to owners.
Efficiently resolve plan-related issues raised by owners and the field.
Create education and resources for the field so they have what they need.
Coach the team on grievance handling and root cause identification to prevent repeat issues.
Other duties as assigned.