Director – National Operations

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Establishes and sustains productive relationships with insurance company representatives for designated national plans.

• Manages the comprehensive operational relationship with assigned national plans across Aspen Dental and WellNow, covering grievances, rate validation, educational outreach, and any other operational matters that impact the plan.

• Actively seeks opportunities to enhance support for Aspen offices, optimize processes with plans, and boost transparency and issue resolution for offices and owners.

• Supervise and engage in Joint Operating Committees (JOCs) for assigned national plans, fostering ongoing results with plan partners.

• Ensures that audits are conducted monthly for national plans to verify accurate network information and expedite the resolution of contract data issues.

• Recognizes trends across markets and collaborates with department heads to develop educational resources for the plans.

• Manages the distribution of field education and company initiatives to the field as required.

• Serves as an expert resource on escalated contractual and compliance matters for national plans.

• Monitors contract performance and other provisions to ensure compliance, identify challenges, and resolve disputes.

• Addresses escalated contract issues raised by operational department heads.

• Collaborates with payors and Aspen Department Leadership (Legal/Compliance, Finance, Centralized Billing, and IT) on strategic business development initiatives to ensure geographic coverage, plan and service types, and optimal reimbursement rates.

⛳️ Requirements

• Bachelor's degree required.

• Highly proactive individual with strong critical thinking abilities and the capability to design solutions rather than merely highlight problems.

• Direct experience in insurance and provider contracting is essential. Must have actively participated in managed care contracting or contract strategy tasks, rather than being adjacent to them.

• Significant exposure to healthcare operations is required. Dental experience is not mandatory; medical or other clinical operations experience is acceptable.

• A minimum of 7 years of progressively responsible management or supervisory level managed care contracting experience in a payor or healthcare environment, with a preference for experience across multiple brands or business lines.

• Comprehensive knowledge of healthcare insurance, billing, reimbursement, administration, systems, practices, and principles (e.g., Medicare, Medicare Advantage, and Commercial).

• Proficient in employing negotiation techniques and practices to advocate for providers effectively.

• Exceptional verbal and written communication skills.

• Strong time management, prioritization, and organizational capabilities.

• Detail-oriented with a high level of analytical and problem-solving skills.

• Proficient in the use of Microsoft Office Suite.

🏝️ Benefits

• Paid time off.

• Health insurance.

• Dental insurance.

• Vision insurance.

• 401(k) savings plan with matching contributions.