Credentialing Services Supervisor

Delta Dental of Arizona, the state’s #1 dental and vision insurance company, is seeking a Credentialing Supervisor with a strong leadership mindset and exceptional analytical and problem-solving skills to join our Credentialing team.

The Credentialing Supervisor’s role is to oversee day-to-day operations of a team consisting of all elements of the Credentialing process. Assist in ensuring the coordination of initial and ongoing compliance with National Committee for Quality Assurance (NCQA) and Delta Dental Plans Association standards including the National Provider File (NPF). Ensures that development and execution of Credentialing and other provider onboarding functions are in accordance with applicable department policies and procedures. Works directly with provider services associates, providers and external clients to ensure satisfaction and timeliness. Generates performance measures. Sets goals and monitors performance against goals. 

About You

If you’re a leader wanting to make an impact. This role will help you with a chance to guide and support a team, improve processes, and ensure a smooth and efficient credentialing experience from start to finish.

You have a strong attention to detail and a problem-solving mindset, allowing you to confidently oversee workflows, maintain accuracy, and meet important timelines. You’re organized, able to balance multiple priorities, and take pride in helping your team stay on track and perform at their best.

Collaboration comes naturally to you to build strong relationships with internal teams, providers, and external partners, and communicate clearly to keep everyone aligned. You’re proactive, take ownership of your work, and are always looking for ways to improve processes, support your team, and the overall experience.

Sound like you? Keep reading, we’d love to tell you more!

Essential Duties

• Coordinates directly with the Director of Compliance to ensure alignment with all departmental and company initiatives, performance guarantees, and internal operational targets.
• Act as the company’s administrator between Symplr and DDMI to ensure the provider systems are working as expected. 
• Monitors key performance indicators and metrics to assess provider enrollment & credentialing effectiveness, efficiency, and compliance. 
• Responsible for continuous process improvement in provider enrollment and credentialing processes including standardized “Tool Kits”, training programs, and deployment of plans.
• Maintain all providers’ contractual credentialing information for all Networks including Medicare Advantage and Medicaid. 
• Run regularly scheduled reports to identify and address any outstanding applications, issues, and expiring information.
• Assist in development, implementation and maintenance of processes that support department and organization goals.
• Monitors the team’s production, quality metrics, and workload distribution, including monthly and yearly review processes for each associate with focus on tangible SMART goals.
• Coordinates with HR to establish and conduct the hiring process and secondary downstream training/support for new associates.
• Provides cross departmental support for various activities related to necessary PR and claims support.
• Coordinates problem solving and quality improvement procedures by interacting with other departments to resolve current issues and avoid potential problems, ensuring customer satisfaction and improving business processes.
• Compiles statistical information, collects feedback from staff regarding dental offices and distributes results to management.
• Assists with provider related concerns regarding the credentialing process and tabulates/escalates areas of concern to the credentialing committee for review and determination of a path forward.
• Responsible for any and all audit related matters, including the NPF audit and various credentialing audits.
• Performs miscellaneous duties as assigned.
• Serves as back-up support for other members of credentialing team. 

The pay range for this position is $67,700 - $93,500 per year. This position is remote

• Bachelor’s degree from an accredited college or university or equivalent experience.
• Experience in the dental field preferred.
• Supervisory experience preferred.
• Working knowledge of state and federal insurance regulations, ERISA, and ASO agreements. Working knowledge of credentialing standards and processes.
• Understanding of dental insurance products and industry trends.
• Proven customer service and relationship building skills
• Solid analytical and problem-solving skills.
• Excellent verbal and written communication skills
• Proficiency in Microsoft Word, Excel, Outlook, and PowerPoint.
• Process and project management experience required.
• Ability to coach and support a cohesive team.

About Us
 

Delta Dental of Arizona’s vision is simple: healthier lives for everyone. That’s why we’ve made it our mission to create a path to better health and wellness. We’re transforming from a single line insurance company to a multi-line health and wellness organization with a foundation that has awarded millions in grants to non-profits who care for our most vulnerable residents by offering dignity and hope.

Our employees enjoy competitive compensation and comprehensive benefits, including medical, dental, vision, 401(k), student loan assistance, six weeks of paid parental leave, volunteer PTO, and a culture that embraces collaboration, service, integrity, and inclusion. At about 150 employees, we cultivate a work community where all employees are known by name, and everyone’s contributions are visible, noticed, and celebrated. 

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.