Strategic Network Operations Director

L.A. Care; Los Angeles (CA); On-site; USD 206,000 - 351,000; Full time

Benefits offered by this job

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

L.A. Care Health Plan in Los Angeles, CA, seeks a Senior Director, Network Operations to lead network operations, ensure regulatory alignment, and drive strategic initiatives across provider networks.

You will supervise a high-performance team and manage workflows, reporting, and communications with Compliance, Legal, and stakeholders. The role emphasizes translating mandates into practical workflows, overseeing hospital-directed payments and rate initiatives, and delivering executive-level

Qualifications

• Bachelor's Degree required; Master's degree preferred.
• 10+ years in managed care or health plan operations.
• Experience leading staff and large programs.
• Experience translating regulatory requirements into workflows.
• Strong communication and collaboration across departments.

Responsibilities

• Oversee network operations to meet strategy and regulatory requirements.
• Identify gaps, implement process improvements, and develop leadership reports.
• Lead regulatory implementation with Compliance and Legal as partners.
• Provide strategic oversight for managed care programs and reporting.
• Direct provider communications and maintain program manuals and materials.
• Hire, train, coach, and motivate the network operations team.

Skills

Medi-Cal contracts

APL implementation

Network adequacy

Regulatory audits

Cross-functional collaboration

Provider networks

Education

Bachelor's Degree

Master's Degree

Job description

L.A. Care Health Plan in Los Angeles, CA, seeks a Senior Director, Network Operations to lead network operations, ensure regulatory alignment, and drive strategic initiatives across provider networks.

You will supervise a high-performance team and manage workflows, reporting, and communications with Compliance, Legal, and stakeholders. The role emphasizes translating mandates into practical workflows, overseeing hospital-directed payments and rate initiatives, and delivering executive-level