Dental Provider Network Lead | Credentialing & Partnerships

Enlightened; Washington (District of Columbia); Hybrid; USD 75,000 - 95,000; Full time

Job summary

Enlightened is seeking a Dental Provider Network Account Executive in Washington, DC. The role focuses on developing and maintaining strong relationships with dental providers and ensuring credentialing, contracting, enrollment, and data accuracy across systems.

This is a hybrid position with four days in the office and one remote day each week. The successful candidate will coordinate onboarding, manage provider records, and collaborate with internal teams to support network operations and

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or an equivalent combination of education and experience.
• Three (3) or more years of experience in provider network management, provider relations, credentialing, provider enrollment, contracting, or healthcare operations.
• Experience supporting provider credentialing and enrollment activities.
• Working knowledge of managed care, Medicaid, Medicare, or commercial health plans.
• Strong organizational and time management skills with the ability to manage multiple priorities.
• Excellent verbal and written communication skills.
• Strong customer service and relationship management skills.
• Proficiency with Microsoft Office, including Excel, Word, and Outlook.

Responsibilities

• Manage the end-to-end provider credentialing and recredentialing process.
• Coordinate new provider enrollment from application through approval.
• Partner with delegated credentialing teams to ensure provider files are complete and regulatory requirements are met.
• Follow up with providers to obtain missing documentation and resolve credentialing deficiencies.
• Prepare provider contracts and coordinate execution with internal leadership.
• Maintain accurate provider records within LIFT and other provider management systems.
• Coordinate provider site visits required for credentialing and recredentialing.
• Support provider contracting activities, including new provider onboarding and ongoing provider maintenance.
• Manage provider additions, terminations, demographic updates, practice location changes, and provider profile maintenance.
• Maintain accurate provider information within Skygen to support claims processing and network operations.
• Coordinate provider site visits with American Dental Systems.
• Investigate and resolve provider claims and reimbursement issues.
• Serve as the primary operational contact for participating dental providers.
• Build and maintain strong relationships with Federally Qualified Health Centers (FQHCs), private dental practices, and group dental practices.
• Monitor Medicaid Identification Numbers (MAIDs) for participating providers and provider groups.
• Ensure provider records remain compliant with organizational, contractual, and regulatory requirements.
• Identify opportunities to improve operational processes and workflow efficiencies.
• Collaborate with internal departments to support provider network initiatives.
• Participate in weekly, biweekly, and monthly operational meetings, as well as cross-functional projects.

Skills

Provider Network Management

Provider Relations

Provider Credentialing

Provider Contracting

Managed Care Operations

Medicaid

Provider Data Management

Regulatory Compliance

Cross-Functional Collaboration

Relationship Management

Process Improvement

Attention to Detail

Education

Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or related field

Tools

Skygen

LIFT

Job description

Enlightened is seeking a Dental Provider Network Account Executive in Washington, DC. The role focuses on developing and maintaining strong relationships with dental providers and ensuring credentialing, contracting, enrollment, and data accuracy across systems.

This is a hybrid position with four days in the office and one remote day each week. The successful candidate will coordinate onboarding, manage provider records, and collaborate with internal teams to support network operations and