Director, Provider Network Management

About the role

Scripps Health Administrative Services supports our five hospital campuses, 31 outpatient centers, clinics, emergency rooms, urgent care sites, along with our 17,000 employees, more than 3,000 affiliated physicians and 2,000 volunteers. Located in La Jolla, San Diego.

Responsibilities

• Oversee the credentialing, provider database, contracting, and provider relations teams.
• Lead provider relations functions, including training, problem-solving, and provider satisfaction initiatives for all medical groups, IPAs, institutional providers, and ancillary providers.
• Be responsible for Customer Service related to both member and provider inquiries.
• Maintain provider directories for all contracted IPAs and medical groups.
• Support Scripps' integrated delivery system.
• Manage relationships related to Scripps Health Plan's plan-to-plan risk arrangements with major HMO plans.
• Serve in a role that blends financial analysis, contract negotiations, operational efficiency, and system-wide impact, working extensively with Scripps Health Plan Services, stakeholders across the organization, and external providers and vendors.

Requirements

• At least seven years combined experience in management of provider relations and contracting at the plan, medical group /IPA level of which four years must be in a leadership capacity.

Qualifications

• Masters degree in healthcare administration or similar.
• Epic Tapestry experience.
• Negotiation skills, creating policies and procedures and leading multiple teams.

Skills

• Financial analysis.
• Contract negotiations.
• Operational efficiency.
• System-wide impact.

Benefits

• Recognized nationally for excellence.
• Top rankings from Great Place to Work and Becker’s Healthcare.
• Award-winning Workplace.
• Transitional and professional development programs.
• Nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.

Pay

Position Pay Range: $72.71-$105.41/hour