Provider Network Operations Leader

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

Job summary

PacificSource Health Plans is seeking an experienced leader to oversee Provider Network operations, including relations, data management, credentialing, and interoperability across Medicaid, Medicare, and Commercial lines.

The role drives strategic planning, efficiency, and cross-department collaboration while ensuring regulatory compliance and high performance. Travel and leadership responsibilities are included in a dynamic health plan environment.

Qualifications

• Minimum 8 years in a leadership role overseeing healthcare provider network operations.
• Bachelor’s degree in business, healthcare administration, finance, or related field.
• Experience leading multiple teams in a matrixed organization preferred.

Responsibilities

• Oversee Provider Network Operations including provider relations, data management and credentialing.
• Lead cross-departmental strategic planning and execution to meet objectives.
• Ensure compliance with state, federal, and NCQA standards across networks.

Skills

Leadership experience

Provider network operations

Strategic planning

Cross-functional collaboration

Education

Bachelor’s degree

Assoc degree + experience

High school diploma + experience

Tools

HIPAA knowledge

Job description

PacificSource Health Plans is seeking an experienced leader to oversee Provider Network operations, including relations, data management, credentialing, and interoperability across Medicaid, Medicare, and Commercial lines.

The role drives strategic planning, efficiency, and cross-department collaboration while ensuring regulatory compliance and high performance. Travel and leadership responsibilities are included in a dynamic health plan environment.