Change Management and Quality Assurance Lead

The Change Management and Quality Assurance Lead role is accountable for leading quality assurance and regulatory execution across provider credentialing recredentialing and provider data management activities. This role ensures Guardian meets delegated credentialing audit requirements maintains regulatory compliance and delivers consistent highquality outcomes through disciplined quality programs and effective change management.

You will lead a team of Quality Assurance Specialists while partnering closely with credentialing network services compliance and technology stakeholders. Through strong project management documentation rigor and oversight of regulatorydriven process changes you will help ensure Guardians operations remain compliant scalable and aligned with evolving regulatory expectations including increased use of automation and AIenabled capabilities.

You Will:

• Lead and develop a team of Quality Assurance Specialists responsible for credentialing and provider data quality oversight.
• Establish and maintain quality assurance programs supporting credentialing recredentialing and provider demographic and directory data changes.
• Ensure timely and successful completion of delegated credentialing audits partnering with internal stakeholders to address findings and sustain compliance.
• Project manage regulatoryrelated process changes ensuring requirements are clearly translated into operational execution.
• Serve as the primary point of contact for regulatorydriven changes impacting credentialing and network services processes.
• Document and maintain Standard Operating Procedures (SOPs) for new or updated processes implementing followup controls to measure adherence and effectiveness.
• Ensure clear timely communication of procedural changes to impacted teams supporting understanding and consistent adoption.
• Partner with technology and operations teams to support quality assurance for new tools automation and AIenabled solutions as human tasks are replaced or augmented.
• Monitor regulatory trends and providerfacing notice requirements ensuring appropriate operational technology and communication updates are coordinated and executed.
• Support continuous improvement by identifying quality risks control gaps and opportunities to strengthen regulatory and operational outcomes.

You Have:

• Experience leading quality assurance or regulatory operations in a healthcare insurance or provider network environment.
• Strong knowledge of credentialing recredentialing and provider data management processes.
• Proven ability to project manage regulatory or compliancedriven process changes from requirement through implementation.
• A strong process documentation and control mindset with experience developing SOPs and monitoring adherence.
• Experience supporting audits and regulatory reviews with the ability to translate findings into sustainable operational improvements.
• Comfort partnering with technology teams to support quality oversight for automation and AIenabled capabilities.
• Strong communication skills with the ability to clearly convey complex regulatory changes to operational teams.
• A continuousimprovement mindset and the ability to lead through change while maintaining quality and compliance.

Location Work Arrangement and Travel:

• The work arrangement for this position will be hybrid (three days per week in a local Guardian Office; two days per week working from home).
• Preferred locations include Bethlehem PA; Boston MA; Holmdel NJ and New York NY.
• Occasional travel required

Salary Range:

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education experience knowledge and abilities of the successful addition to salary this role may also be eligible for annual sales or other incentive compensation.

Our Promise

At Guardian youll have the support and flexibility to achieve your professional and personal goals. Through skill-building leadership development and philanthropic opportunities we provide opportunities to build communities and grow your career surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardians Purpose to inspire well-being we are committed to offering contemporary supportive flexible and inclusive benefits and resources to our colleagues. Explore our company benefits at apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age race color creed religion sex affectional or sexual orientation national origin ancestry marital status disability military or veteran status or any other classification protected by applicable law.

Accommodations

Guardian is committed to providing access equal opportunity and reasonable accommodation for individuals with disabilities in employment its services programs and also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individuals known limitations related to pregnancy childbirth or related medical conditions unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process to perform essential job functions and/or to receive other benefits and privileges of employment please contact . Please note: this resource is for accommodation requests only. For all other inquires related to your application and careers at Guardian refer to the Guardian Careers site.

Visa Sponsorship

Guardian is not currently or in the foreseeable future sponsoring employment order to be a successful applicant. you must be legally authorized to work in the United States without the need for employer sponsorship.

Notice Regarding Guardians Use of Artificial Intelligence in Recruitment

As part of Guardians job application process Guardian may use artificial intelligence tools (AI Tools) to automate the sorting and filtering of information provided by applicants as part of its preliminary screening. This preliminary screening may be used to help identify applicant materials and resumes relative to their indication that the applicant meets the requirements for the specific job for which they are applying as specified in the listing posted on Guardians jobs website (Careers at Guardian at At Guardian we do not use AI Tools to substantially assist or replace human judgment or discretionary decision making in our hiring process. All hiring decisions will be made by Guardian colleagues.

Please be aware that if you apply for a specific position with Guardian you will have the choice of opting out of Guardians use of AI Tools during the job application process. If you would like to request an alternative process that does not utilize AI Tools or would like to request a reasonable accommodation within ten business days of your position application you must email your request to making sure to provide your name and job requisition identification number. Guardian will retain your applicant materials and resume and all information therefrom in accordance with Guardians document retention policy a copy of which you may request via .

Additionally at applicable times Guardian will make public the most recent bias audit results for such AI tools which may be found here.

Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.