Director, Provider Network Strategy & Contracting

Scripps Health; San Diego (CA); On-site; USD 150,000 - 190,000; Full time

Job summary

Scripps Health in San Diego seeks a Director, Provider Network Management to build and maintain a contracted provider network for Scripps Health Plan members. You will oversee credentialing, contracting, provider relations, and data integrity across IPAs and medical groups, while partnering with Plan Services and stakeholders to improve network performance.

This role blends financial analysis, operations, and strategic leadership to strengthen the network and support the integrated delivery

Qualifications

Responsibilities

• Oversee credentialing, provider database, contracting, and provider relations teams.
• Lead provider relations functions, including training, problem-solving, and provider satisfaction initiatives for all medical groups, IPAs, institutional providers, and ancillary providers.
• Be responsible for Customer Service related to both member and provider inquiries.
• Maintain provider directories for all contracted IPAs and medical groups.
• Support Scripps' integrated delivery system. Scripps Health Plan operates as both an MSO and a KK-licensed plan for large commercial groups.
• Manage relationships related to Scripps Health Plan's plan-to-plan risk arrangements with major HMO plans.

Job description

Scripps Health in San Diego seeks a Director, Provider Network Management to build and maintain a contracted provider network for Scripps Health Plan members. You will oversee credentialing, contracting, provider relations, and data integrity across IPAs and medical groups, while partnering with Plan Services and stakeholders to improve network performance.

This role blends financial analysis, operations, and strategic leadership to strengthen the network and support the integrated delivery