Head of Provider Network Operations & Planning

BrightonOne; Boston (MA); Hybrid; USD 120,000 - 180,000; Full time

Job summary

BrightonOne is a nonprofit social enterprise delivering healthcare, housing, and hope to veterans and military-connected families, with enterprise discipline in service to those who served.

The Associate Director, Provider Network Operations & Planning leads back-office operations ensuring the US Family Health Plan’s provider network is accurate, adequate, and compliant. It includes provider data management, credentialing, analytics, and coordination with platform vendors.

Qualifications

• Bachelor's degree required; Master's degree preferred.
• 8+ years in provider network operations, provider data, or credentialing with leadership.
• 2+ years of experience with credentialing applications and provider data management systems.

Responsibilities

• Oversee provider data management operations and credentialing processes to ensure accuracy and timeliness.
• Monitor and report certification/credentialing metrics and support audits or accreditation reviews.
• Collaborate with cross-functional teams to improve workflows and drive performance metrics.

Skills

URAC/NCQA

Provider data management

Leadership

Data analysis

Reporting

Education

Bachelor's degree

Master's degree

Job description

BrightonOne is a nonprofit social enterprise delivering healthcare, housing, and hope to veterans and military-connected families, with enterprise discipline in service to those who served.

The Associate Director, Provider Network Operations & Planning leads back-office operations ensuring the US Family Health Plan’s provider network is accurate, adequate, and compliant. It includes provider data management, credentialing, analytics, and coordination with platform vendors.