Director, Provider Network Operations & Data Governance

Community Health Choice, Inc.; Houston (TX); Hybrid; USD 140,000 - 195,000; Full time

Job summary

Community Health Choice, Inc. seeks a Director of Network Operations to lead provider network strategy, governance, and data integrity, ensuring timely regulatory submissions and strong cross-functional collaboration.

The role partners with Contracting, Credentialing, Claims, Compliance, IT, and Quality to strengthen data accuracy and operational excellence. Ten years in managed care and five in leadership are preferred.

Qualifications

• Ten (10) or more years of progressively responsible experience in managed care or health plan operations.
• Five (5) or more years of formal people-leadership experience in a regulated environment.
• Experience with Texas Medicaid, CHIP, STAR+PLUS, Marketplace, Medicare, or other government-sponsored programs.

Responsibilities

• Develop and execute the provider network operations strategy and governance.
• Ensure regulatory reporting accuracy and audit readiness across state and federal requirements.
• Lead, coach, and develop network operations staff and cross-functional teams.
• Partner with multiple departments to resolve network operational issues and improve end-to-end processes.

Skills

Strategic leadership

Cross-functional collaboration

Executive communication

Regulatory reporting

Analytical thinking

Education

Bachelor's degree in Healthcare Administration or related field

Master's degree preferred

Tools

Microsoft 365

Excel

Power BI

SQL

Salesforce

QNXT

Job description

Community Health Choice, Inc. seeks a Director of Network Operations to lead provider network strategy, governance, and data integrity, ensuring timely regulatory submissions and strong cross-functional collaboration.

The role partners with Contracting, Credentialing, Claims, Compliance, IT, and Quality to strengthen data accuracy and operational excellence. Ten years in managed care and five in leadership are preferred.