Director – National Operations

🔥 6 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $160k - $175k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

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TAG - The Aspen Group

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

Healthcare Insurance

TAG - The Aspen Group is a company focused on revolutionizing the healthcare sector by enhancing patient care and experience in various areas, including dentistry and walk-in medical care. The group supports its brands to break down barriers in dental care, foster professional growth, and make significant contributions to the healthcare industry. With a commitment to empowering its teams, The Aspen Group aims to restore smiles and confidence, making healthcare accessible and compassionate.

📋 Description

• Develops and maintains 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 looks 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. • Ensures audits occur monthly for national plans to confirm accurate network information and drive quick resolution of contract data issues. • Identifies trends across markets and partners with department heads to build educational resources for the plans. • Oversee the distribution of field education and company initiatives to the field as needed. • Acts as an expert resource on escalated contractual and compliance issues for national plans. • Monitors contract performance and other provisions to assure compliance, identify problem areas, and resolve disputes. • Resolves escalated contract issues generated by operational department heads. • Works 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.

🎯 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

🏖️ Benefits

• paid time off • health • dental • vision • 401(k) savings plan with match