Director, Provider Network Operations

PacificSource Health Plans

Director of Provider Network Operations overseeing healthcare provider strategies and initiatives for PacificSource. Leading efforts to enhance provider collaboration and ensure operational excellence across divisions.

Posted 6/26/2026full-timeFlorida • 🇺🇸 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 teams to ensure success in meeting objectives
Develop, direct and execute efforts to meet Credentialing division objectives
Lead initiatives to ensure seamless integration and ongoing operational effectiveness of provider network platforms
Foster partnerships with software vendors and internal stakeholders
Ensure integrated systems support compliance with state, federal, and NCQA standards
Oversee division budgets and spending
Monitor spending versus the planned budget throughout the year

Requirements

What you’ll need

Minimum of 8 years in healthcare operations required
Management experience required
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 managementcompliance

Soft Skills

collaborationleadershipstrategic planningcommunicationbudget management