The Provider Network Operations Manager supports the Director of Provider
Network Operations in the strategic and operational oversight of Provider
Relations and PN Operations and Service Development teams. This position is
responsible for managing supervisor-level staff, driving operational excellence,
supporting provider network initiatives, improving processes, and ensuring
effective collaboration across departments. The Manager partners with leadership
to develop standardized workflows, improve efficiency, enhance team performance,
and support organizational goals related to provider engagement, network
adequacy, and operational effectiveness.
This position is fulltime remote. Selected candidate must reside in North
Carolina. Some travel for onsite meetings to the Home office at Morrisville may
be required.
Responsibilities & Duties
Manage Unit Operations
Support the Director of Provider Network Operations in overseeing daily
operations of Provider Relations and PN Operations and Service Development
teams
Monitor team performance, service metrics, and operational outcomes
Ensure operational priorities align with organizational goals and strategic
initiatives
Assist with planning, implementation, and evaluation of department objectives
Directly supervise Provider Relations Supervisor and Supervisor PN Operations
and Service Development
Provide coaching, mentorship, and performance management to supervisory staff
Promote a culture of accountability, collaboration, customer service, and
continuous improvement
Support workforce planning, staff development, succession planning, and
employee engagement initiatives
Partner with supervisors to identify training needs and professional
development opportunities
Identify opportunities to streamline workflows and improve operational
efficiency
Develop, implement, and monitor standardized processes, tools, and procedures
across Provider Relations and PN Operations and Service Development functions
Collaborate with supervisors and staff to evaluate operational challenges and
implement sustainable solutions
Recommend process improvement initiatives that reduce administrative burden,
improve consistency, and increase effectiveness
Measure and report on the effectiveness of process improvement initiatives
Staff Management and Development
Work with Human Resources and the Director of Provider Network Operations to
attract, maintain, and retain a highly qualified and well-trained workforce
Ensure staff are well trained in and comply with all organization and
department policies, procedures, and business processes
Organize workflows and ensure staff understand their roles and
responsibilities
Ensure the department has the needed tools and resources to achieve
organizational goals and to support employees and ensure compliance with
licensure, regulatory, and accreditation requirements
Actively establish and promote a positive, diverse, and inclusive working
environment that builds trust
Ensure all staff are treated with respect and dignity
Ensure standards are transparent and applied consistently, impartially, and
ethically over time and across all staff members
Work to resolve conflicts and disputes, ensuring that all participants are
given a voice
Set goals for performance and deadlines in line with organization goals and
vision
Effectively communicate feedback and provide ongoing coaching and mentoring
to staff and support a learning environment to advance team skills and
professional development
Cultivate and encourage efforts to expand cross-team collaboration and
partnership
Manage and Analyze Reports
Develop and analyze operational reports, dashboards, and performance metrics
Monitor departmental goals and key performance indicators
Provide recommendations to the Director of Network Operations regarding
operational improvements and strategic opportunities
Ensure compliance with organizational policies, documentation standards, and
regulatory requirements
Collaborate with Internal Departments
Partner with Contracting, Claims, Quality, Care Management, Finance, and
other departments to support provider and operational needs
Facilitate communication and coordination between teams to address system and
process issues
Participate in organizational initiatives impacting provider network
performance and operations
Manage Projects
Take a lead role with special projects related to provider relations,
operations and development
Assist Director Provider Network Operations with development of project
action plans, participate in special projects as needed to evaluate
operational requirements
Minimum Requirements
Education & Experience
Bachelor’s degree from an accredited college or university in a Human Services,
Education, Sociology, Business, Public Administration, or related field and
seven (7) years of experience in community, business, or governmental programs
in health related fields, including two years of supervisory, consultative or
administrative experience.
Prior experience with Standard Plan or Tailored Plan preferred.
Or
Master’s degree from an accredited college or university in a Human Services,
Education, Sociology, Business, Public Administration, or related field and
three (3) years of experience in community, business, or governmental programs
in health related fields, including two years of supervisory, consultative or
administrative experience.
Prior experience with Standard Plan or Tailored Plan preferred.
Knowledge, Skills, & Abilities
General knowledge of Provider Contract requirements
General healthcare knowledge
Knowledge of database systems for reporting and transmission of data
Thorough knowledge of Microsoft Office Suite, particularly MS Word and MS
Excel
Strong interpersonal skills with ability to communicate with appropriate
staff
Demonstrated supervision skills
Problem solving skills
Ability to identify and correct credentialing reporting issues via Microsoft
Excel and credentialing database
ability to manage several projects
Ability to prepare technical reports
Salary Range
$103,799-$132,344/Annually
Exact compensation will be determined based on the candidate's education,
experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility