Strategic Director of Provider Network Operations

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

Job summary

PacificSource Health Plans in Oregon seeks a senior leader to oversee the Provider Network operations, including Provider Relations, Credentialing, and Data Management. You will guide strategic initiatives, manage cross-functional teams, and ensure policy and regulatory compliance across Medicaid, Medicare, and Commercial lines.

The role emphasizes stakeholder collaboration with IT, Analytics, and Operations, driving interoperability, data integrity, and LEAN improvements while developing a

Qualifications

• Minimum of 8 years in a leadership role overseeing provider network operations.
• Experience leading Provider Relations, Credentialing, or Provider Data Management preferred.
• Bachelor’s degree in business, health care administration, finance, or related field.

Responsibilities

• Guide strategic initiatives for the Provider Network Operations division and manage KPIs.
• Oversee provider network platforms interoperability with legacy and new systems.
• Develop provider education programs and relationships to enhance collaboration.
• Partner with IT and operations to ensure compliance with state, federal, and NCQA standards.
• Hire, coach, and evaluate direct reports.

Skills

Accountable leadership

Strategic planning

Coaching and developing others

Operational decision making

Customer focus

Education

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

Job description

PacificSource Health Plans in Oregon seeks a senior leader to oversee the Provider Network operations, including Provider Relations, Credentialing, and Data Management. You will guide strategic initiatives, manage cross-functional teams, and ensure policy and regulatory compliance across Medicaid, Medicare, and Commercial lines.

The role emphasizes stakeholder collaboration with IT, Analytics, and Operations, driving interoperability, data integrity, and LEAN improvements while developing a