Director, Provider Network Operations

About the role

For our client, we are seeking a Director Provider Network Operations to join the team of a leader in the Finance & Insurance space. This role will lead operational priorities where safety, quality, compliance, and execution discipline are central to success. You will collaborate with field leadership, support functions, and cross-functional stakeholders to improve accountability, service delivery, and operational consistency. The position offers the opportunity to influence operational scale, customer outcomes, and organizational performance within a regulated financial services environment.

Responsibilities

• Guide strategic initiatives for the Provider Network Operations division
• Collaborate with analytics teams to meet Credentialing division objectives
• Develop strategies for provider education and relationship management
• Lead initiatives for integration and operational effectiveness of provider network platforms
• Ensure compliance with state, federal, and NCQA standards
• Develop automated workflows for data synchronization across platforms
• Strengthen relationship management frameworks with provider partners

Qualifications

• 8 years of experience in healthcare operations including management roles
• Expertise in provider reimbursement methodologies and data management
• Demonstrated ability to develop and execute strategies in a matrixed organization
• Strong collaboration skills with provider leaders and department heads
• Bachelor's degree in business, healthcare administration, or related field required

Benefits

• Opportunities for professional growth and development
• Collaborative work environment with cross-departmental projects
• Travel opportunities of approximately 15%
• Direct influence on provider engagement and satisfaction strategies