Director, Provider Network Operations

PacificSource Health Plans

Director of Provider Network Operations at PacificSource guiding strategic initiatives for healthcare operations. Collaborating with various teams to enhance provider engagement and optimize network operations.

Posted 6/26/2026full-timeRemote • North Carolina • 🇺🇸 United StatesLead💰 $108,468 - $184,396 per yearWebsite

About the role

Key responsibilities & impact

Guide strategic initiatives for the Provider Network Operations division.
Collaborate with Provider Reimbursement Insights and Analytics Team.
Develop, direct and execute efforts to meet Credentialing division objectives.
Lead initiatives to enhance provider collaboration, engagement, and satisfaction.
Collaborate with IT teams to identify interoperability gaps.
Ensure integrated systems support compliance with state, federal, and NCQA standards.
Develop automated workflows and processes for data synchronization.
Strengthen relationship management frameworks for consistent communication.
Actively participate in department strategic planning and execution.
Oversee provider collaborative efforts in coordination with key departments.
Guide division functional leaders in developing successful business plans.
Design and deliver provider education programs.
Regularly assess provider feedback for relationship improvements.

Requirements

What you’ll need

Minimum of 8 years in healthcare operations required.
Management experience required.
Must have expertise in provider reimbursement methodologies, provider relations, data management and compliance.
Experience developing, communicating, and executing strategy in a matrixed organizational structure.
Bachelor’s degree in business, health care administration, finance, or related field required.
Candidates with an associate’s degree and 2 years of relevant experience, or a high school diploma and 4 years of relevant experience will also be considered.

Benefits

Comp & perks

Flexible telecommute policy
medical, vision, and dental insurance
incentive program
paid time off and holidays
401(k) plan
volunteer opportunities
tuition reimbursement and training
life insurance
options such as a flexible spending account

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

provider reimbursement methodologiesdata managementcomplianceautomated workflowsdata synchronizationstrategic planningbusiness plansprovider education programs

Soft Skills

leadershipcollaborationrelationship managementcommunicationengagementsatisfaction assessment