Senior Director, Provider Network Operations & Strategy

PacificSource; United States; Remote; USD 108.000 - 184.000; Vollzeit

Zusammenfassung

PacificSource seeks a senior leader to oversee the Provider Network Operations, aligning Provider Relations, Credentialing, and Data Management with enterprise goals. You will direct cross-functional programs, ensure policy compliance, and drive performance across Medicaid, Medicare, and Commercial lines.

The role requires 8+ years in healthcare network operations leadership, strong data and vendor interoperability experience, and a focus on education and relationship management with providers.

Qualifikationen

• Minimum of 8 years of experience in a leadership role overseeing healthcare provider network operations.
• Experience leading Provider Relations, Credentialing, or Provider Data Management is strongly preferred.
• Knowledge of provider reimbursement methodologies and healthcare data management is required.

Aufgaben

• Oversee Provider Network divisions including Provider Relations, Provider Data Management, Credentialing, and provider platform interoperability.
• Lead initiatives to ensure compliance with state, federal, NCQA standards and organizational policies.
• Develop and execute strategies for provider education and relationship management to enhance collaboration and satisfaction.
• Partner with IT and analytics teams to optimize interoperability and data synchronization across platforms.

Kenntnisse

Provider Network Operations

Provider Relations

Credentialing

Provider Data Management

Strategic Planning

Ausbildung

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

Jobbeschreibung

PacificSource seeks a senior leader to oversee the Provider Network Operations, aligning Provider Relations, Credentialing, and Data Management with enterprise goals. You will direct cross-functional programs, ensure policy compliance, and drive performance across Medicaid, Medicare, and Commercial lines.

The role requires 8+ years in healthcare network operations leadership, strong data and vendor interoperability experience, and a focus on education and relationship management with providers.