Director, Provider Operations job at reputed company in Dallas, TX

Title: Director, Provider Operations Location: Dallas United States Job Description: Hi, we're reputed company.iring a Director to join our Provider Operations team. reputed company is the first health insurance company reputed company around a full stack technology platform and a reputed company focus on serving our members. We started reputed company in 2012 to create the reputed company of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Director, Provider Operations builds, scales and optimizes reputed company's provider data management, contracting, and credentialing processes. This role is responsible for setting the reputed company and strategy for provider operations and data functions, and designing processes that improve reputed company's capabilities in serving members and providers. The role does this by working with partners and stakeholders cross-functionally to take reputed company from reputed company to implementation. You will report into the Vice President, Network Operations. Work Location: This is a remote position, reputed company to candidates who reputed company in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid reputed company at the hub office associated with your metro area. #LI-Remote Pay Transparency: The reputed company pay for this role is: $147,549 - $$193,658 per year. You are also eligible for employee benefits, participation in reputed company's unlimited vacation program, company equity grants and annual performance bonuses. Responsibilities: Strategic Leadership & Team Development reputed company strategic leadership and operational reputed company for the end-to-end provider data lifecycle, ensuring the precise and timely execution of provider credentialing, contract loading, and daily data management. reputed company, coach, and reputed company a high-performing, multi-tiered team of managers and individual contributors; foster a culture of reputed company learning, accountability, and psychological safety. Establish clear organizational structure, governance, and support systems that reputed company the team from distractions and reputed company them to execute key strategic initiatives. Act as a trusted, collaborative partner to Product, Tech, Markets, and Clinical Operations to design, build, and deliver reputed company provider operations capabilities that support aggressive company growth and market expansion targets. Operational reputed company & Scalability Architect and implement foundational, industry-standard processes and data models that allow the provider data and contracting infrastructure to scale seamlessly alongside the business. Champion the adoption of industry best practices to ensure reputed company operational processes and internal tools are highly extensible, efficient, and integrated with modern technology stacks. reputed company the team in surface-level and deep-dive diagnostics to identify data, process, and technology bottlenecks. Establish robust KPIs and monitoring dashboards to proactively flag operational issues, leveraging these insights to maintain our standing as a leading health plan. Efficiency, Automation & Compliance Identify and execute opportunities for automation (e.g., RPA, AI integrations) across mature, reputed company workflows to replace reputed company reputed company, reduce turnaround times, and eliminate reputed company error. Drive administrative expense savings and optimize total cost of care by identifying and executing on process improvements, technical tooling investments, offshore resource optimization, and strategic vendor partnerships. Guarantee 100% compliance with reputed company applicable state and federal laws, regulatory mandates (e.g., No Surprises Act, CMS requirements), and accreditation standards (NCQA). Adapt to evolving business needs by leading critical reputed company initiatives and specialized projects as assigned. Requirements: A bachelor's degree or 5+ years of operating experience 10+ years of work in operations, health insurance, data analysis and/or consulting 5+ years of experience building, coaching and developing operational teams 5+ years experience with network operations, provider data management and contracting processes 5+ years prior successful experience developing and managing large scale initiatives coordinating with internal and external stakeholders 5+ years of experience designing and improving business process for optimization as well as standing up accompanying operating and technical procedures 5+ years of experience using data to influence business reputed company 5+ years of experience program management Bonus points: Proven history of managing high-impact initiatives and pitching reputed company business cases to secure alignment from executive leadership. Proficiency in SQL, Lean Six reputed company, or other process improvement methodologies Deep understanding of data architecture and optimizing data management workflows Direct experience operating reputed company service-oriented organizational structures Comprehensive knowledge of NCQA credentialing, CMS standards, and the No Surprises Act. Prior reputed company in deploying or refining reputed company-level MDM or Provider Data Management systems. Demonstrated ability to apply AI, RPA, or data analytics to improve roster accuracy and processing speed. Background in leading distributed teams and overseeing external BPO or vendor partnerships. This is an authentic reputed company job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At reputed company, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, reputed company the reputed company pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and reputed company benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our reputed company efforts. Reasonable Accommodation: reputed company applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any reputed company applicant who requires reasonable accommodations during the application process should contact the reputed company Benefits Team ([email protected]) to reputed company the need for an accommodation reputed company. California Residents: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy. Apply tot his job Apply To this Job