Role Description This is a fully remote opportunity, giving you the flexibility to lead and support a credentialing team from anywhere. We’re looking for someone who can serve as a subject matter expert in commercial credentialing, so strong experience with commercial insurance is essential (dental experience is a plus). This role requires proven leadership experience, with 3–5 years in a credentialing management capacity, including developing teams and driving performance. - Oversee the Credentialing department to ensure the providers are credentialed in a timely and accurate manner. - Resolve complex issues and work with staff to provide feedback and training to ensure Credentialing processes are completed timely and accurately. - Develop and implement departmental procedures, quality measures, set goals and objectives to ensure effective and compliant workflow. - Foster an environment of continuous improvement through process and systematic efficiencies. - Work in conjunction with Human Resources to evaluate viable candidates under consideration for hire. - Develop and motivate staff; initiate and communicate a variety of personnel actions including employment, terminations, performance reviews, salary reviews, disciplinary actions, and development plans. - Provide regular and behaviorally specific feedback to increase performance levels. - Oversee staff timecard and PTO requests to ensure timely and accurate reporting. - Develop and maintain standard procedures for the Credentialing department. - Assist in resolving complaints and issues for clients, providers, and internal staff. - Develop and maintain training documents to ensure accuracy and thoroughness. - Work effectively and collaboratively with peers and other internal resources in diagnosing and resolving issues. - Identify and report credentialing issues to appropriate departments and leadership. - Assist in the ongoing evaluation of policies and procedures and assist in development and implementation of new efficiencies based on assessments. - Work with Director of Provider Experience to identify, develop and implement best practices. - Serve as subject matter expert for credentialing requirements, including NCQA standards, federal and state regulatory guidelines, and accreditation-related expectations. - Provide leadership and guidance on credentialing policies, procedures, and operational practices. - Monitor credentialing performance for large clients and drive corrective actions. - Identify opportunities to improve consistency, reporting, and operational performance across large client credentialing processes. - Act as an expert in area of credentialing and accreditation practices. - Ensure all departmental processes meet organization and industry standards. - Provide regular reporting and status updates to clients and participate in client meetings. - Must comply with registering and creating your own id.me account or using your personal id.me account for identity verification. Qualifications - 2 year/Associate degree in Business or related field. - 3 - 5 years of experience in credentialing management capacity. - Ability to organize and report on large amounts of data. - Ability to organize work appropriately to meet deadlines. - Ability to successfully lead teams. - Demonstrated ability to make appropriate decisions when faced with conflicting deadlines or needs. - Demonstrated use of Microsoft Office products (Word, Excel, PowerPoint). Requirements - 2 year or 4 year degree in Business Administration or similar field (preferred). - Experience with dental, commercial (preferred). - Knowledge of Enterprise System (preferred). Benefits - Compensation Range: $85,284 - $127,926. - Compensation Midpoint: $106,605. Company Description SKYGEN is the trusted partner for specialty benefits payers and government agencies responsible for the delivery and administration of dental and vision benefits. Through cutting-edge technology and service solutions, SKYGEN empowers clients to become the most efficient, effective healthcare organizations in the country.

• Lead and manage Technical Implementation Leads and Software Developers delivering customer-facing healthcare interoperability implementations and strategic customer initiatives. • Provide hands-on technical leadership across discovery, solution design, estimation, implementation planning, troubleshooting, testing, deployment, and operational readiness activities. • Lead technical implementation delivery across multiple concurrent customer projects while ensuring delivery quality, scalability, maintainability, and alignment with customer expectations. • Provide hands-on technical guidance for HL7 FHIR, HL7 v2, CDA/CCDA, REST APIs, data mapping, SQL, validation, integration workflows, troubleshooting, and implementation best practices. • Participate in customer-facing technical discussions, escalations, root cause analysis, mitigation planning, writing executive summaries, and implementation troubleshooting activities. • Collaborate closely with Product, QA, CloudOps, Support, Architecture, Agile Leads, and Customer Success teams to deliver scalable and supportable customer solutions. • Develop and maintain reusable implementation assets including buildbooks, implementation playbooks, troubleshooting guides, reference architectures, and solution/problem pattern libraries. • Identify recurring implementation challenges, operational gaps, customer pain points, and technical risks and translate them into actionable process improvements, feature requests, and bug reports. • Drive implementation quality through technical reviews, implementation standards, testing practices, peer mentorship, and reduction of delivery defects and rework. • Mentor, guide, and support Technical Implementation Leads and Software Developers through technical coaching, prioritization guidance, workload management, and professional development. • Ensure implementation work is properly documented through Jira, technical documentation, testing evidence, operational handover materials, and implementation standards. • Research, evaluate, and recommend technologies, implementation patterns, and operational improvements for new and existing customer solutions and platform capabilities.

Role Description The Network Quality Manager is responsible for operational quality oversight, governance, monitoring, reporting, audit readiness, and quality improvement activities supporting provider data operations across medical and dental networks. This role ensures: - Provider data integrity - Provider directory accuracy - Network adequacy support - Credentialing quality support functions - Exception/fallout management activities This role supervises and manages daily operations of auditors and analyst team. The Quality Manager is responsible for: - End-to-end and all aspects of quality business process activities - Quality planning, assurance, control, and improvement - Supporting risk reduction, auditing life-cycle activities, cost and productivity savings, reporting, and quality improvement initiatives Monitors performance and completes system analysis in specific areas of quality including: - Claims - Appointment Scheduling - Provider Data - Customer Service - Appeals & Grievances The role partners cross-functionally with: - Provider Data Operations - Network Operations - Network Adequacy - Credentialing - Compliance - Quality teams This role supports: - Increase of quality metrics for operational business units - Audit Calibrations with internal and external partners - Audit Governance: Approves audit methodologies, sampling plans, and scoring standards - Reporting & Stakeholder Communication - Cost / productivity savings - Risk reduction - Error / defect reduction - Process waste reduction - Continuous improvement efforts You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Qualifications - 2+ years of Team Lead/SME experience with demonstrated abilities in Leadership and Emotional Intelligence - 1+ years of auditing experience - 1+ years of experience analyzing and solving customer problems - Experience supporting quality, operational oversight, provider data, network operations, credentialing, compliance, or related operational functions - Experience working with operational metrics, reporting, quality monitoring, and process improvement activities - Experience working independently in less structured environments with moderately complex operational issues - Experience communicating operational risks, findings, and recommendations to leadership and stakeholders - Ability to work Monday - Friday, 8:00 am - 5:00 pm in Central Time Zone Requirements - Lean, Six Sigma, Quality, HRO, or process improvement experience - Experience supporting healthcare operations, provider data operations, network management, or quality assurance programs - Experience supporting contractual quality requirements, audit readiness, or compliance monitoring activities - Experience with quality management systems, operational controls, or performance monitoring frameworks - Knowledge of provider directory operations, provider data management, network adequacy requirements, or credentialing operations Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

• Assist the subsidence and surveying team with site inspections, technical assessments, and general case management. • Maintain accurate and up‑to‑date records on the company’s claims management IT system. • Work with Regional Technical Managers to improve quality and service delivery during the repair stage of claims. • Review contractor tenders and report findings to Regional Technical Managers. • Ensure on‑site compliance with CDM legislation and site‑specific safety requirements. • Support with contract administration, cost analysis, valuations, and preparation of final accounts. • Manage complaints in line with company procedures and relevant legislation. • Visit damaged properties to assess technical and insurance requirements and oversee reinstatement works. • Communicate effectively with clients, policyholders, local authorities, third parties, and internal colleagues. • Manage a regional caseload independently and support other regions when required. • Maintain a suitable home office environment; attend local offices as required. A company car is provided, and a full driving licence is essential. • Assess repair requirements and prepare schedules of work. • Instruct temporary or emergency works to make buildings safe. • Apply knowledge of building pathology, including asbestos and damp. • Interpret buildings insurance policies and relevant insurance law. • Produce professional reports and technical correspondence. • Specify site investigations and interpret geotechnical reports. • Understand building construction and foundation systems. • Obtain and assess competitive tenders. • Apply Planning and Building Regulations knowledge. • Comply with Health & Safety and CDM Regulations. • Apply the Party Wall etc. Act where required. • Administer building contracts and apply contract law principles. • Manage projects on site, including valuations, variations, and payment authorisations. • Demonstrate cost control and financial awareness. • Use MS Office and internal systems confidently.