Director, Provider Network Management - SCRIPPS HEALTH : Job Details

This position is in San Diego and requires local residency.

Eligible to participate in the Director Incentive Plan.

Elevate your career with Scripps Health, where Compassion Meets Excellence.

Invest, Empower & Belong. At Scripps Health, your potential is limitless. We're more than a healthcare provider; at Scripps, you will join a community where your views, beliefs, and values are celebrated. Grow through industry-leading development programs and empower yourself to deliver innovative care. Be a part of an extraordinary team, impacting health in beautiful San Diego.

At Scripps Health, your ambition is empowered, and your abilities are appreciated:

• Nearly a quarter of our employees have been with Scripps Health for over 10 years.
• Scripps is a Great Place to Work Certified company for 2025.
• Scripps Health has been consistently ranked as a top employer for women, millennials, diversity, and as an overall workplace by various national publications.
• Beckers Healthcare ranked Scripps Health on its 2024 list of 150 top places to work in health care.
• We have transitional and professional development programs to create a learning environment that enables you to thrive in your specific field as well as in your overall career.

As Director, Provider Network Management, you will be responsible for creating and maintaining a comprehensive contracted provider network to serve SHPS members.

Oversee provider relations functions including training, problem solving, and satisfaction for all medical groups, IPAs, institutional, and ancillary providers.

Be responsible for Customer Service for both member and provider inquiries.

Maintain provider directories for all contracted IPAs and medical groups.

Scripps is an integrated delivery system.

Scripps Heath Plan is both an MSO and a KK licensed plans for large commercial groups.

SHPS also assumes risk with major HMO plans.

Required Education/Experience/Specialized Skills:

• At least seven years of experience in management of provider relations and contracting at the plan, medical group/IPA level, with four years in a leadership capacity.

Preferred Education/Experience/Specialized Skills/Certification:

• Masters degree in healthcare administration or similar.
• Proficiency in reporting (pivots) and Epic Tapestry.