Senior Director, Provider Network Operations

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

Job summary

PacificSource Health Plans seeks a senior leader to oversee the Provider Network department, including Provider Relations, Credentialing, and Provider Data Management. The role drives cross-division collaboration to maintain performance metrics across Medicaid, Medicare, and Commercial lines.

Travel is required ~15%. A Bachelor’s degree and 8+ years in healthcare leadership are required, with strong experience in strategy, policy, and interoperability across IT and operations.

Qualifications

• Minimum 8 years of leadership experience in healthcare provider networks.
• Experience overseeing Provider Relations, Credentialing and Data Management preferred.
• Ability to develop and execute strategy in a matrixed organization.

Responsibilities

• Guide strategic initiatives for Provider Network Operations and data platforms.
• Oversee Credentialing, Provider Data Management and Provider Relations teams.
• Ensure compliance with state, federal, and NCQA standards.
• Lead interoperability efforts between provider platforms and legacy systems.
• Manage annual IT and department budgets and resource planning.

Skills

Provider Network Leadership

Credentialing Expertise

Provider Data Management

Strategic Planning

Stakeholder Collaboration

HIPAA Compliance

Education

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

Job description

PacificSource Health Plans seeks a senior leader to oversee the Provider Network department, including Provider Relations, Credentialing, and Provider Data Management. The role drives cross-division collaboration to maintain performance metrics across Medicaid, Medicare, and Commercial lines.

Travel is required ~15%. A Bachelor’s degree and 8+ years in healthcare leadership are required, with strong experience in strategy, policy, and interoperability across IT and operations.