Provider Network Operations Director (Remote-NC)

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Provider Network Operations Director (Remote-NC) in the United States.

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.
• Requirements:
• Bachelor’s degree in Mental Health, Public Health, Social Work, Psychology, Education, Sociology, Business, or Public Administration (Master’s preferred).
• Minimum of 5 years’ experience in network operations, provider relations, or management within health, social work, or educational programs.
• At least 3 years of supervisory, consultative, or administrative experience.
• Comprehensive knowledge of mental health, substance use, intellectual/developmental disabilities, and related service delivery systems.
• Strong understanding of Medicaid Transformation, LME/MCO operations, accreditation standards, and network adequacy principles.
• Excellent leadership, negotiation, problem-solving, and interpersonal skills.
• Proficiency in Microsoft Office and ability to analyze data to evaluate program effectiveness.
• NC residency required; ability to travel as needed.
• Benefits:
• Competitive compensation package with annual incentive bonus plan.
• Medical, dental, and vision insurance with low deductible/low-cost options.
• Generous vacation and sick leave accrual; 12 paid holidays.
• State retirement (pension plan) and 401(k) with employer match.
• Company-paid life and disability insurance.
• Wellness programs and public service loan forgiveness eligibility.
• Remote work option within North Carolina.

Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.

When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.

🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.

📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.

🎯 Based on this analysis, we automatically shortlist the three candidates with the highest match to the role.

🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.

The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role. Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team.

Thank you for your interest!

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