Director, Provider Network Management

Description Location: La Jolla, San Diego This position is eligible to participate in the Director Incentive Plan. Founded in 1924, Scripps Health is a $5 billion, private nonprofit health system based in San Diego, founded in 1924 by philanthropist Ellen Browning Scripps. Serving over 600,000 patients annually, it operates five acute-care hospitals, 30 outpatient centers, and a wide physician network of 3,000 affiliated doctors and 17,800 employees. Recognized nationally for excellence, Scripps has earned top rankings from Great Place to Work and Becker's Healthcare and maintains an AA rating with a stable outlook from S&P Global Ratings due to its strong leadership and financial performance. What will you do? 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. Scripps Health Plan operates as both an MSO and a KK-licensed plan for large commercial groups. Manage relationships related to Scripps Health Plan's plan-to-plan risk arrangements with major HMO plans. Create and maintain a comprehensive contracted provider network to serve Scripps Health Plan members. Qualifications Required Education/Experience/Specialized Skills: At least seven years combined experience in management of provider relations and contracting at the plan, medical group/IPAs level, of which four years must be in a leadership capacity. Preferred Education/Experience/Specialized Skills/Certification: Masters degree in healthcare administration or similar; Epic Tapestry experience; negotiation skills, creating policies and procedures and leading multiple teams. Benefits & Compensation Benefit Status: Full-time with benefits. Minimum Rate: $72.71 - Maximum Rate: $105.41 per hour. In compliance with the California Pay Transparency Act, Scripps Health posts the pay range for all jobs. Pay will be determined based on relevant experience and internal equity within the pay range. This range is applicable for employees who reside in California only. A geographical pay differential may be applied for remote employees who reside out of state. Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability. Location Primary Location: Central San Diego County - SCRIPPS HEALTH PLAN SERVICES Work Locations: 10790 RANCHO BERNARDO ROAD 4S-300, SAN DIEGO, 92127 #J-18808-Ljbffr Scripps Health