Director, Network Operations
Based in United StatesFull-TimeDirector
SalaryCompetitive base salary aligned with senior leadership benchmarks. Performance-based bonus and equity opportunities.
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Job Details
- Experience
- 8+ years of senior leadership experience
- Required Skills
- LeadershipArtificial Intelligence
Requirements
- 8+ years of senior leadership experience in healthcare network operations, provider data management (PDM), or credentialing.
- Deep subject matter expertise in Provider Data Management systems and provider “golden record” frameworks.
- Strong understanding of CMS network adequacy requirements and provider directory compliance rules.
- Deep knowledge of NCQA credentialing standards.
- Proven experience managing third-party vendors and BPaaS providers accountable to SLAs.
- Demonstrated success implementing AI, automation, or advanced analytics to improve operational workflows.
- Strong leadership experience managing and scaling remote or distributed teams.
- Excellent cross-functional influence skills to align clinical, technical, and compliance stakeholders.
- Strong analytical mindset with experience using dashboards and metrics to guide strategic decisions.
- Exceptional communication and executive presence.
Responsibilities
- Own the end-to-end strategy, architecture, and execution of the Provider Data Management (PDM) ecosystem.
- Ensure accuracy, integrity, and CMS-compliant publication of provider directories.
- Lead enterprise credentialing operations in partnership with clinical leadership, ensuring execution of Credentialing Committee processes.
- Oversee third-party credentialing vendors and BPaaS partners, establishing performance metrics and enforcing SLAs.
- Drive AI and automation initiatives, including the use of LLMs and advanced data tools for validation and anomaly detection.
- Lead and scale a fully remote network operations team.
- Act as the primary escalation and decision-maker for complex operational issues across clinical, compliance, and technology teams.
- Define and execute a long-term vision for network operations modernization, including development of a provider “Golden Record.”
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