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Director Of Provider Solution Jobs (NOW HIRING)

Colorado Access

Director of Provider Contracting

Denver, CO · On-site

$150K - $185K/yr

We are looking for a DIRECTOR OF PROVIDER CONTRACTING who can help shape our vision and support our mission. Here is what the position will look like. Department Director Responsibilities: * Develop ...

Ccrmivf

$125K - $155K/yr

This position oversees and supports a team of Physician Liaisons while maintaining full ownership and accountability for an assigned territory. Reporting directly to the Senior Director of Provider ...

Unity ILS Inc

Director Service Provider

Anaheim, CA · On-site

$20/hr

As a Direct Service Provider, you'll support individuals with disabilities or special needs in ... As a leading provider of support services, Unity ILS offers comprehensive solutions tailored to the ...

iaedp

Provider Relations Director

Franklin, TN · On-site

$115K - $130K/yr

As a leading provider of mental health treatment services across the region with multiple ... Director of OP Provider Relationship, Outpatient Network, focuses on mobilizing business ...

uMed

Head of Provider Partnerships (US)

OR · Remote

Enhanced Parental Leave The Role You will own the growth and strategy of uMed's entire US provider and partner network. This isn't a single-pipeline sales role, it's building the strategy, the team ...

AccorHotel

Director of Engineering

Los Angeles, CA · On-site

Director of Engineering Fairmont Century Plaza is looking for a dynamic leader who is highly ... Identify issues and provide solutions, inclusive of outsourcing and managing 3rd party companies

uMed

Head of Provider Partnerships (US)

OR · On-site +1

Enhanced Parental Leave The Role You will own the growth and strategy of uMed's entire US provider and partner network. This isn't a single-pipeline sales role, it's building the strategy, the team ...

Pathway Health Services

Director of MDS

Minneapolis, MN · On-site

The Director of MDS will work with the clinical team to help ensure compliance with all state and ... Identify problems, collaborate with staff, and provide solutions regarding situations, implementing ...

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How much do director of provider solution jobs pay per year?

As of Sep 10, 2026, the average yearly pay for director of provider solution in the United States is $100,880.00, according to ZipRecruiter salary data. Most workers in this role earn between $70,000.00 and $131,500.00 per year, depending on experience, location, and employer.

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Infographic showing various Director Of Provider Solution job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 76% Full Time, 15% Part Time, and 6% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $100,880 per year, or $48.5 per hour.

Director of Provider Operations

Bloomington, MN • On-site

HealthPartners
See more jobs at HealthPartnersexternal

$67.65 - $101.47/hr

Full-time

Re-posted 14 days ago

HealthPartners rating

7.5

Company rating: 7.5 out of 10

Based on 138 frontline employees who took The Breakroom Quiz

Job description


HealthPartners is hiring a Director of Provider Operations. This role provides strategic and operational leadership for Provider Operations with accountability for provider enrollment, provider data and directory operations, network maintenance and configuration, trading partner connectivity, provider portal operations, provider data management, and provider compliance and regulatory operations. They will direct department strategy, people, and performance to ensure accurate provider data, effective operational execution, regulatory readiness, and strong cross-functional coordination, while leading complex initiatives, managing vendor and external partner relationships, and representing the organization in industry and regulatory forums to advance business objectives and operational excellence.
MINIMUM QUALIFICATIONS:
  • Education, Experience or Equivalent Combination:
    • Bachelor degree in health care, business, public administration, IT, project management or related field
    • 7 years experience in health care or insurance industry, health-related project management, provider data/operations or provider network management
    • 5 years in a leadership or management role
  • Knowledge, Skills, and Abilities:
    • Strong understanding of health plan operation workflows from provider contracting to enrollment to claims processing and payments.
    • Working knowledge of regulatory requirements for Medicare, Medicaid, and Commercial lines of business.
    • Proven ability to lead cross-functional teams and manage complex projects.
    • Proficiency in data analysis and reporting tools (e.g., Excel, SQL, PowerBI).
    • Excellent communication, negotiation, and stakeholder management skills.
    • Ability to work in a fast-paced, matrixed environment with competing priorities.
    • Strong interpersonal and collaborative skills to lead and influence teams at all levels of the organization.
    • Solid analytical, project and financial management skills.
    • Ability to offer creative, cost-effective alternatives and options to solve problems and meet customer needs.
    • Strong oral and written communications.

PREFERRED QUALIFICATIONS:
  • Education, Experience or Equivalent Combination:
    • Education: Master's degree in health care management, health care, business, public administration or related field
    • Experience: 10+ years of experience in provider operations or network management with 5+ years in a senior leadership role overseeing multi-line health plan operations (Commercial, Medicare, Medicaid)
  • Licensure/ Registration/ Certification:
    • Six Sigma or PMP (Project Management Professional) certification
    • CPHQ (Certified Professional in Healthcare Quality)
    • WEDI (Workgroup for Electronic Data Interchange) member
  • Knowledge, Skills, and Abilities:
    • Strong understanding of complex data hierarchies and system architecture
    • Working knowledge of HIPAA transactions and related EDI standards
    • Demonstrated ability to establish, monitor, and manage service level agreements
    • Experience leveraging automation and AI-enabled solutions within provider data operations

ESSENTIAL DUTIES:
Strategic Leadership (40%):
  • Develop and execute a comprehensive provider operations strategy aligned with organizational goals and regulatory requirements.
  • Partner with IT and other health plan system owners to develop an integrated enterprise-wide provider data platform.
  • Lead cross-functional initiatives to enhance provider data accuracy and implement cost effective enrollment processes to facilitate quick provider on-boarding, claims submissions and provider payments.

Provider Enrollment Oversight (30%):
  • Oversee contracted provider end-to-end provider data lifecycle including intake of roster and enrollment forms, maintenance of provider data, network participation management, clearinghouse, EFT and web portal enrollment
  • Oversee vendor relationships and performance, ensuring accountability and ROI.

Compliance & Quality (20%):
  • Ensure adherence to federal and state regulations, including CMS and Medicaid guidelines.
  • Collaborate with Provider Relations & Network Management, Legal, Compliance, and Claims teams to mitigate risk and ensure audit readiness.

Analytics & Reporting (10%):
  • Leverage analytics to identify trends, root causes, and opportunities for improvement.
  • Develop and present executive-level reporting on savings, compliance and workload impacts.
  • Monitor data accuracy and turnaround times to ensure internal or compliance goals are met

Team Development (5%):
  • Build and lead a high-performing team of analysts, auditors, and managers.
  • Foster a culture of continuous improvement, innovation, and accountability.

LEADERSHIP RESPONSIBILITY:
Key Areas of Responsibility Include:
Provider Enrollment: Owner of contracted provider enrollment and implementation of various state, national or accreditation requirements ensuring accurate and timely provider information is available to health plan members
  • Network Participation Management: Partner with Provider Relations & Network Management and other administrative teams to develop networks that meet market needs and maintain regulatory compliance.

  • Provider Data Management: In coordination with IT and other administrative systems develop integrated enterprise-wide provider data platform.

  • EDI Trading Partnerships: Oversee clearinghouse strategy and monitor to ensure contract compliance.

  • Provider portal: Responsible for secure account registration management, fraud mitigation and escalation if potential fraud is identified. Monitor effectiveness of portal and impacts to call centers.

  • Innovation (R&D): Conducts research and development to support compliance needs and cost-effective workflow improvements to support functions of the department. Identify and gather ideas from other sources (internally & externally). Assess use and enablement of advanced technologies (AI, gLLM, etc...) with IT input.

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