Supervisor, Credentialing and Regulatory Operations

Guardian Life Insurance • Boston, MA

3d • Hybrid

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.

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.

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.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 1,001-5,000 employees