Head of Provider Network Operations

PacificSource; Boise (ID); Sur place; USD 108 000 - 184 000; Plein temps

Résumé du poste

PacificSource seeks a Director of Provider Network Operations to lead the department’s core functions across Medicaid, Medicare, and Commercial lines. You will oversee Provider Relations, Credentialing, and Provider Data Management, ensuring data integrity, regulatory compliance, and high performance against enterprise KPIs.

You will shape strategic plans, align with company goals, and manage cross-functional teams to improve interoperability, education, and partner collaboration while guiding

Qualifications

• Experience leading provider network operations, or related functions.
• Experience with provider reimbursement methodologies and compliance.
• Ability to lead matrixed teams and cross-department projects.

Responsabilités

• Guide strategic initiatives for Provider Network Operations, including network setup, data integrity, and audits.
• Develop and execute credentialing strategies and compliance programs.
• Lead provider education and relationship management to improve engagement and satisfaction.
• Oversee integration of provider network platforms with legacy and new systems; ensure interoperability.

Connaissances

Provider Relations

Credentialing

Provider Data Management

Data Management

Leadership

Strategy

Formation

Bachelor’s degree in business, health care administration, finance, or related field

Description du poste

PacificSource seeks a Director of Provider Network Operations to lead the department’s core functions across Medicaid, Medicare, and Commercial lines. You will oversee Provider Relations, Credentialing, and Provider Data Management, ensuring data integrity, regulatory compliance, and high performance against enterprise KPIs.

You will shape strategic plans, align with company goals, and manage cross-functional teams to improve interoperability, education, and partner collaboration while guiding