Provider Network Operations Director (Remote-NC)

This role is ideal for a seasoned leader who will oversee the strategic and operational management of a healthcare provider network. The Provider Network Operations Director will ensure that network design, credentialing, enrollment, data management, and compliance meet regulatory and accreditation standards. You will collaborate with senior leadership and cross-functional teams to support member-focused outcomes, maintain quality and access, and drive continuous improvement. This position emphasizes operational excellence, strategic oversight, and effective provider relationship management across a diverse service array. The role offers a dynamic environment with opportunities to influence network performance and community impact while leading and developing high-performing teams.

Accountabilities: Lead the operational strategy, development, and continuous improvement of the provider network. Oversee provider enrollment, credentialing, contracting, and ongoing network management to ensure compliance with local, state, federal, and accreditation standards. Develop and implement departmental policies, procedures, and goals aligned with organizational objectives and regulatory requirements. Serve as liaison with internal departments, external providers, and community stakeholders to maintain effective relationships and enhance network services. Conduct capacity studies, gap analyses, and implement strategies to expand services and improve access. Provide leadership, coaching, and professional development for the provider network operations team. Ensure accurate provider data management, reporting, and support the implementation of provider portals. Facilitate problem resolution, dispute mediation, and communication between providers, members, and internal teams.