Director, Provider Operations

Overview

Our mission is Better Health. Our passion is helping others.

What’s Your Why?

• Are you looking for a career opportunity that will help you grow personally and professionally?
• Do you have a passion for helping others achieve Better Health?
• Are you ready to join a growing team that shares your mission?
  
  

Why Join Our Team:At Better Health Group, it’s our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day! They support our providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for our patients. We don’t just talk the talk - we believe in it and live by it. Be part of a team that shares your passion and drive, and start living your purpose at Better Health Group.

Responsibilities

Position Objective:

The Director of Provider Operations is responsible for overseeing and managing the affiliate provider network performance and related operational activities for the Florida market by leading a team of regional provider account managers to deliver high-quality, consistent healthcare services aligned with value-based care outcomes. This position will work closely with the VP, Provider Operations to ensure successful department outcomes aligned with Better Health Group goals.

Responsibilities:

• Develop and execute strategies for building and maintaining a robust and high-quality provider network
• Lead a high-performing provider operations team within Fl, focusing on best-in-class account management framework
• Establish clear goals, provide direction, and foster a culture of collaboration, accountability, and excellence within the team
• Cultivate and maintain positive relationships with providers and their representatives
• Serve as the primary point of contact for escalated issues, inquiries, and concerns, ensuring prompt and effective resolution
• Implement and streamline processes related to provider onboarding, credentialing, claims management, and other operational activities
• Continuously identify opportunities to enhance efficiency and reduce administrative burden
• Monitor quality assurance programs to evaluate provider performance, adherence to standards, and patient satisfaction
• Collaborate with the Quality and Compliance teams to address any issues or gaps in service quality
• Ensure compliance with all applicable healthcare regulations, laws, and industry standards related to provider operations
• Stay informed about changes in the regulatory landscape and implement necessary adjustments
• Utilize data and analytics to assess provider network performance, identify trends, and make data-driven decisions to optimize network management and operational efficiency
• Additional duties as assigned
  
  

Position Requirements/ Skills:

• Bachelor's degree in healthcare administration, business management, or a related field preferred
• 7 years combined experience in healthcare provider operations, network management, or related role
• Strong knowledge of healthcare regulations, policies, and procedures
• Understanding of healthcare reimbursement models, provider contracting, and regulatory compliance
• Demonstrated ability to build and maintain relationships with healthcare providers and stakeholders
• Familiarity with learning management systems and other educational technologies
• Proficient with Google Suite (Drive, Docs, Sheets, Slides) and Microsoft Office (Word, Excel, PowerPoint) for real-time collaboration
  
  

Physical Requirements:

• Requires standing, walking, pushing, bending, kneeling, and reaching
• Ability to sit for extended periods of time
• Requires corrected vision and hearing to normal range
• Ability to operate a motor vehicle and have own means of transportation
  
  

Key Attributes/ Skills:

• Has a contagious and positive work ethic, inspires others, and models the behaviors of core values and guiding principles
• An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments
• Is able to work within our Better Health environment by facing tasks and challenges with energy and passion
• Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals
• Demonstrated ability to handle data with confidentiality
• Ability to work cross-functionally with multiple teams; ability to work independently with minimal supervision
• Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
• Excellent written and verbal communication skills; must be comfortable communicating with senior-level leadership, providers, and health plans
• Strong interpersonal and presentation skills
• Strong critical thinking and problem-solving skills
• Must be results-oriented with a focus on quality execution and delivery
• Appreciation of cultural diversity and sensitivity toward target patient populations