Director of Insurance Operations

Kid Clan Services, Inc.; Newark (NJ); On-site; USD 120,000 - 160,000; Full time

Job summary

Kid Clan Services, Inc. in Newark, NJ seeks a Director of Insurance Operations to oversee and strengthen our authorization, credentialing, contracting, eligibility, and benefits functions.

The role focuses on authorizations while overseeing credentialing and contracting activities. The ideal candidate has deep ABA insurance operations experience, can lead teams, improve workflows, and resolve complex payer issues with senior leadership involvement as needed.

Qualifications

• 5+ years of ABA insurance or payer operations experience.
• Hands-on authorizations experience.
• Credentialing and contracting expertise.
• Experience with Medicaid managed care and commercial plans.
• Experience leading teams and improving workflows.
• Multi-state ABA or behavioral health background preferred.

Responsibilities

• Lead the authorization department and ensure timely ABA authorizations.
• Oversee credentialing, contracting, eligibility, and benefits operations.
• Improve credentialing workflows, tracking, and turnaround times.
• Handle payer escalations and build insurer relationships.
• Develop scalable systems to track authorizations and KPIs.
• Collaborate with clinical, intake, billing, and leadership.
• Mentor teams and ensure accountability.

Skills

ABA insurance

Payer operations

Authorization management

Credentialing

Insurance contracting

Provider credentialing

Medicaid knowledge

CPT codes

Eligibility verification

Leadership

Tools

EHR systems

CAQH

Practice management

Spreadsheets

Job description

Director of Insurance Operations

A rapidly growing, multi-state ABA therapy organization is seeking an experienced Director of Insurance Operations to oversee and strengthen our authorization, credentialing, contracting, eligibility, and benefits functions.

We are looking for someone with deep experience in ABA insurance operations who can manage teams, improve workflows, establish accountability, and personally step in to resolve complex insurance issues when necessary.

The majority of this role will focus on authorizations and oversight of the authorization department, while also overseeing credentialing, insurance contracting, eligibility, and benefits operations.

Responsibilities

• Lead and oversee the authorization department, including initial and ongoing ABA authorizations

• Ensure authorization requests, renewals, and follow ups are completed accurately and within required timelines

• Identify authorization delays, denials, and payer issues and drive them toward resolution

• Oversee provider and organizational credentialing with commercial insurance companies and Medicaid plans

• Improve credentialing workflows, tracking, accountability, and turnaround times

• Manage insurance contracting, network participation, payer enrollment, and contracting related follow up

• Oversee eligibility and benefits verification processes

• Oversee insurance contracting, benefits, and authorization processes for Occupational Therapy and Speech Therapy services as applicable

• Ensure benefit information is accurate, complete, and communicated appropriately to internal teams

• Develop scalable systems to track authorizations, credentialing, contracting, benefits, and payer issues

• Manage, train, and hold team members accountable for performance and turnaround times

• Establish and monitor departmental KPIs, aging reports, and outstanding items

• Work closely with clinical, intake, billing, and executive leadership

• Handle complex payer escalations and build productive relationships with insurance companies

• Continuously improve processes as the organization expands across multiple states

Qualifications

• 5+ years of ABA insurance or payer operations experience required

• Significant hands on experience with ABA authorizations required

• Insurance contracting experience required

• Provider and organizational credentialing experience required

• Strong experience with commercial insurance plans and Medicaid managed care organizations

• Strong understanding of ABA CPT codes, authorization requirements, and payer processes

• Experience with eligibility and benefits verification

• Prior experience managing authorization, credentialing, or insurance operations teams

• Experience working within a multi-state ABA or behavioral healthcare organization strongly preferred

• Strong systems and workflow management skills

• Experience using systems to manage workflows, tracking, accountability, and departmental operations

• Strong experience working within an EHR or practice management system and the ability to learn and optimize new systems

• Comfortable working with payer portals, CAQH, Medicaid enrollment systems, reporting tools, and spreadsheets

• Ability to work effectively in a fast paced, high volume environment

• Highly organized with strong follow through and attention to detail

• Strong communication, leadership, and problem solving skills

• Ability to identify inefficient processes and implement stronger systems

• Ability to take ownership of complex issues and drive them through resolution

What We Are Looking For

We are looking for an experienced ABA insurance professional who understands the full insurance lifecycle but has particularly strong expertise in authorizations.

This person should be able to quickly identify where authorization, credentialing, contracting, or benefits processes are breaking down and put systems in place to improve speed, accuracy, visibility, and accountability.

This is not solely a management position. The Director of Insurance Operations should be comfortable getting into the details, handling difficult payer issues, supporting the team through complicated cases, and personally stepping in when an escalation requires senior level involvement.

The ideal candidate understands how insurance operations directly impact client starts, continuity of services, clinical operations, and revenue.

This is an opportunity to take ownership of a critical operational function within a large and rapidly growing multi-state ABA organization and build an insurance operation that can continue to scale with the company.