Head of Provider Network Operations

PacificSource Health Plans; United States; Remote; USD 108,000 - 184,000; Full time

Job summary

PacificSource Health Plans is seeking a senior leader to oversee Provider Network operations, including Credentialing, Data Management, and Provider Relations. The role drives strategic planning, program execution, and interdepartmental collaboration to improve performance across Medicaid, Medicare, and Commercial lines.

The ideal candidate will have 8+ years in healthcare leadership, a business-focused degree, and proven ability to manage large teams while ensuring regulatory compliance.

Qualifications

• Minimum 8 years of leadership experience in healthcare provider network operations or related functions.
• Experience leading Provider Relations, Credentialing, or Provider Data Management is strongly preferred.
• Ability to lead large, multi-level teams and complex portfolios.

Responsibilities

• Guide strategic initiatives for the Provider Network Operations division, including network setup, data integrity, education and service, and contract implementation performance.
• Develop and execute strategies for provider education and relationship management to enhance collaboration and satisfaction.
• Oversee interoperability of provider network platforms with legacy and emerging systems and partner with IT to close gaps.

Skills

Leadership

Strategic Planning

Communication

Cross-functional Collaboration

People Management

Education

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

Job description

PacificSource Health Plans is seeking a senior leader to oversee Provider Network operations, including Credentialing, Data Management, and Provider Relations. The role drives strategic planning, program execution, and interdepartmental collaboration to improve performance across Medicaid, Medicare, and Commercial lines.

The ideal candidate will have 8+ years in healthcare leadership, a business-focused degree, and proven ability to manage large teams while ensuring regulatory compliance.