Director, Provider Network Operations & Strategy

PacificSource Health Plans; Bend (OR); On-site; USD 108,000 - 184,000; Full time

Job summary

PacificSource Health Plans is seeking an experienced leader to oversee the Provider Network operations, including relations, data management, credentialing, and platform interoperability. You will align multiple departments with the company strategy and drive performance across Medicaid, Medicare, and Commercial lines.

This role requires minimum 8 years in healthcare leadership, a bachelor’s degree in a related field, and the ability to manage large teams, budgets, and strategic projects.

Qualifications

• Minimum 8 years of leadership in provider network operations.
• Experience leading Provider Relations, Credentialing, or Data Management.
• Bachelor’s degree in business, healthcare administration, finance, or related field.
• Knowledge of provider reimbursement methodologies and healthcare data management.
• Ability to lead in a matrixed organization.

Responsibilities

• Guide strategic initiatives for Provider Network Operations.
• Collaborate with IT and analytics to meet objectives.
• Develop provider education and relationship management strategies.
• Oversee integration of provider network platforms with legacy systems.
• Hire, coach, and conduct performance reviews.
• Oversee division budgets and resource planning.

Skills

Leadership

Financial acumen

Strategic planning

Influential communication

Situational leadership

Change management

Education

Bachelor’s degree (business/health care admin/finance)

Associate degree + 2+ years relevant experience or high school diploma + 4+ years

Job description

PacificSource Health Plans is seeking an experienced leader to oversee the Provider Network operations, including relations, data management, credentialing, and platform interoperability. You will align multiple departments with the company strategy and drive performance across Medicaid, Medicare, and Commercial lines.

This role requires minimum 8 years in healthcare leadership, a bachelor’s degree in a related field, and the ability to manage large teams, budgets, and strategic projects.