Chief Provider Network Operations & Strategy

PacificSource

Charlotte (NC)

Remote

USD 140,000 - 210,000

Full time

6 days ago

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Job summary

PacificSource in Charlotte, NC seeks a Senior leader to oversee the Provider Network Operations, including Provider Relations, Credentialing, and Data Management. You will drive performance across Medicaid, Medicare, and Commercial lines and align with the company’s strategy.

You will lead cross‑functional teams, shape educational programs for providers, ensure compliance with state and federal standards, and partner with IT and analytics to optimize workflows and interoperability.

Qualifications

Minimum of 8 years in a leadership role overseeing healthcare provider network operations or related functions.
Experience managing large, multi‑level teams and complex portfolios.
Knowledge of provider reimbursement methodologies, compliance, and healthcare data management.
Bachelor's degree in business, health care administration, finance, or related field.

Responsibilities

Oversee Provider Network divisions and cross‑department planning and execution.
Guide network setup, data integrity, provider education and service, contract implementation and audits.
Ensure compliance with state, federal, and NCQA standards; align with organizational policies.
Develop and execute strategies for provider education and relationship management.
Partner with IT, Analytics, Operations to optimize interoperability and workflows.