Senior Supervisor, Individual Dental Operations

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

📋 Description

• Spearhead quality assurance initiatives that promote operational excellence within the Individual Dental sector.

• Develop and uphold quality monitoring systems, auditing methodologies, evaluation benchmarks, and reporting mechanisms.

• Assess operational performance, customer interactions, vendor engagements, and business processes for compliance with established standards and requirements.

• Examine quality trends and pinpoint opportunities to enhance operational efficiency, customer outcomes, and overall business performance.

• Direct the intake, triage, tracking, investigation, and resolution of intricate customer issues.

• Supervise inquiries from the Department of Insurance, executive escalations, Exchange-related requests, Access to Care issues, complaints, grievances, and other customer-related matters.

• Assist with internal, external, enterprise, and regulatory audit processes.

• Organize audit evidence, supporting documents, business responses, audit programs, monitoring initiatives, and tracking of corrective actions.

• Oversee compliance with Federal Exchange, State-Based Exchange, Department of Insurance, and business requirements.

• Analyze operational data, audit outcomes, complaints, quality review findings, and business metrics to detect trends.

• Perform root cause analyses and propose process enhancements.

• Collaborate with Operations, Customer Service, Compliance, Risk Management, vendor partners, enterprise teams, and business leadership.

• Deliver findings, recommendations, and performance results to management and stakeholders.

• Lead, coach, mentor, and cultivate a team dedicated to quality reviews, audit processes, customer escalations, and complaint resolution.

• Set performance expectations, manage workload distribution, and assist with onboarding, training, performance evaluations, and recognition efforts.

⛳️ Requirements

• A Bachelor's Degree or equivalent business experience is mandatory.

• Minimum of 5 years experience in healthcare, insurance operations, quality assurance, auditing, compliance, customer service, claims, enrollment, or related business areas.

• At least 2 years of leadership or supervisory experience is preferred.

• Comprehensive understanding of Individual and Family Plan operations, dental products, customer service, and operational workflows.

• Experience in supporting quality assurance, audit activities, complaints, grievances, escalations, or regulatory inquiries.

• Familiarity with Federal Exchange, State-Based Exchange, Department of Insurance, or other regulatory frameworks is preferred.

• Strong analytical abilities with a proven track record of identifying trends, conducting root cause analyses, and formulating actionable recommendations.

• Exceptional verbal and written communication skills.

• Strong organizational skills, prioritization abilities, and stakeholder management expertise.

• Capability to operate effectively in intricate, fast-paced, and highly regulated environments.

• If working remotely, a wired broadband or fiber optic internet connection with minimum speeds of 10Mbps download and 5Mbps upload is essential.

🏝️ Benefits

• Occasional or permanent remote/home working is allowed, contingent upon having a cable broadband or fiber optic internet service with a minimum of 10Mbps download and 5Mbps upload.

• A tobacco-free policy and eligibility for smoking cessation programs in applicable states.