P
Director, Provider Network Operations
PACIFICSOURCE
Posted: 10/20/2026
Director, Provider Network Operations
PacificSource Health Plans
Posted: 10/20/2026Director, Provider Network Operations
PacificSource Health Plans
Posted: 10/20/2026Director, Provider Network Operations
PacificSource Health Plans
Posted: 10/20/2026P
Director, Provider Network Operations
PACIFICSOURCE
Posted: 10/20/2026P
Director, Provider Network Operations
PACIFICSOURCE
Posted: 10/20/2026
Principal Associate, Project Management – Debit Operations Network Releases
Capital One
Posted: 10/20/2026PMP
Senior Associate, Network Control
L3Harris Technologies
Posted: 10/19/2026DAC
Associate, Network Control
L3Harris Technologies
Posted: 10/19/2026
Corporate Counsel – Network Operations
T-Mobile
Posted: 10/16/2026
Network Operations Specialist, Government
AT&T
Posted: 10/16/2026iOSServiceNowTypeScript
Senior Network Operations Analyst
CVS Health
Posted: 10/16/2026
Senior Manager, Network Operations
Providence
Posted: 10/16/2026
Vice President, Network Operations
Fidelity Investments
Posted: 10/15/2026AnsibleCloudITSMPython
Network Operations Analyst II
PDI Technologies
Posted: 10/13/2026AWSCloudDNSITSMSwitchingTCP/IP
Coordinator – Network Operations
HonorHealth
Posted: 10/13/2026
NOC Technician, Tier 1
WorldNet Telecommunications LLC
Posted: 10/13/2026FirewallsTCP/IPVoIP
Senior Network Analyst/Technician – NOC, Information Technology
Emory University
Posted: 10/9/2026
Senior Managing Counsel – Pharmacy Network Operations
The Cigna Group
Posted: 10/7/2026
NOC Engineer
The ProActive Technology Group
Posted: 10/7/2026AzureCloudVMware
P
Director, Provider Network Operations
PACIFICSOURCEPosted 10/20/2026full-timeRemote • North Carolina • United StatesLead💰 $108,469 - $184,397 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive experience in healthcare provider network operations, including provider relations, credentialing, and data management. Proven ability to develop and execute strategic initiatives while ensuring compliance with regulatory standards and enhancing operational effectiveness.
Highest-signal resume keywords
Provider Network Operations LeadershipProvider Reimbursement MethodologiesCompliance Requirements KnowledgeStrategic Planning and ExecutionTeam Development and Management
About the role
Key responsibilities & impact- Guide strategic initiatives for Provider Network Operations, including network setup and maintenance, provider data integrity, provider education and service, contract implementation, provider-related claims, provider setup and audits, corrective action plans, and provider directory accuracy
- Collaborate with Provider Reimbursement Insights and Analytics to meet objectives
- Direct Credentialing division objectives and ensure compliance and operational excellence
- Develop provider education and relationship-management strategies
- Lead integration and operational effectiveness of provider network platforms with legacy and emerging systems
- Partner with software vendors, IT teams, operational leaders, and internal stakeholders to improve interoperability and system compatibility
- Ensure integrated systems comply with state, federal, and NCQA standards and organizational policies
- Develop automated workflows for accurate data synchronization across platforms and departments
- Improve functionality through LEAN methodologies and resources
- Participate in strategic planning, execution, resource allocation, and performance monitoring
- Work with executive leadership to align processes, technology, and people resources with performance and efficiency targets
- Oversee provider collaborative efforts and guide division functional leaders in developing business plans
- Design and deliver provider education programs covering network policies, reimbursement processes, and regulatory requirements
- Assess provider feedback and implement relationship improvements
- Collaborate with Operations, IT, Health Services, Analytics, Finance, and other departments
- Oversee annual IT work plans, initiative work plans, financial budgets, and resource needs
- Develop coaching and training programs with division leaders
- Oversee hiring, staff development, coaching, and performance reviews for direct reports
- Enhance employee engagement within Provider Network
- Oversee division budgets and spending and implement corrective actions as needed
- Participate in Manager/Supervisor meetings, PRISM walks, internal committees, and department activities
- Assess innovative provider payment methodologies for approval and implementation
- Perform other duties as assigned
Requirements
What you’ll need- Minimum of 8 years of experience in a leadership role overseeing healthcare provider network operations or related functions
- Experience leading at least two of Provider Relations, Credentialing, and Provider Data Management strongly preferred
- Demonstrated experience managing large, multi-level teams and complex operational portfolios
- Knowledge of provider reimbursement methodologies, provider network operations, compliance requirements, and healthcare data management
- Experience developing and executing strategy within a matrixed organization preferred
- Bachelor’s degree in business, health care administration, finance, or related field required
- Associate’s degree and 2 years of relevant experience, or high school diploma and 4 years of relevant experience, in addition to the required minimum years of work experience will also be considered
- Ability to develop and execute strategy
- Advanced knowledge of provider reimbursement and reimbursement methodologies, provider relations, or provider partnership activities in relevant markets and geography
- Ability to lead people in a matrixed organization structure and build high performing teams
- Proven collaborative interaction experience with provider leaders
- Ability to read and comprehend both written and spoken English
- Ability to communicate clearly and effectively
- Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing/sorting/filing motions, and lift and carry files and business materials
- Must meet department and company performance and attendance expectations
- Must follow PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information
Benefits
Comp & perks- Work from home designation (WFH: NC)
- Equal opportunity employment
- Employee engagement and cultural enhancement programs
- Coaching and training programs
- Travel opportunities/requirements approximately 15% of the time
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Provider Data ManagementCredentialingHealthcare Data ManagementLEAN MethodologiesAutomated Workflow DevelopmentPerformance MonitoringBudget ManagementProvider Education Program DesignRelationship Management StrategiesInnovative Payment Methodologies
Soft Skills
Effective CommunicationCollaborative InteractionTeam LeadershipEmployee EngagementCoaching and Training
Tools & Technologies
Provider Network PlatformsIT SystemsData Synchronization ToolsPerformance Monitoring ToolsFinancial Budgeting Software
Industry Keywords
Healthcare ComplianceNCQA StandardsProvider RelationsMatrixed OrganizationHIPAA Regulations