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Director Provider Network Development information

What are some common challenges faced by a Director of Provider Network Development, and how can they be addressed?

A Director of Provider Network Development often encounters challenges such as negotiating favorable contracts with providers, ensuring network adequacy, and balancing cost control with quality of care. Successfully addressing these issues requires strong relationship-building skills, an in-depth understanding of healthcare regulations, and the ability to analyze market trends. Collaborating closely with legal, compliance, and analytics teams can help streamline contract negotiations and maintain a competitive, high-performing network. Continual professional development and staying current with industry changes are also key for long-term success in this role.

What is the difference between Director Provider Network Development vs Provider Network Manager?

AspectDirector Provider Network DevelopmentProvider Network Manager
CredentialsBachelor's degree, industry certifications often preferredBachelor's degree, relevant certifications beneficial
Work EnvironmentStrategic planning, high-level decision making, cross-department collaborationOperational management, provider relations, network oversight
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth plans, healthcare providers, insurance firms
Search & Comparison IntentStrategic development, network expansion, leadership rolesOperational management, provider relations, network maintenance

The main difference is that the Director Provider Network Development focuses on strategic growth and high-level planning of provider networks, while the Provider Network Manager handles day-to-day operations and provider relations. Both roles require industry knowledge and relevant certifications, but their scope and responsibilities differ significantly.

What are the key skills and qualifications needed to thrive as a Director of Provider Network Development, and why are they important?

To thrive as a Director of Provider Network Development, you need a deep understanding of healthcare networks, contract negotiation, and provider relations, typically supported by a bachelor’s or master’s degree in healthcare administration or a related field. Familiarity with healthcare analytics platforms, provider management systems, and knowledge of payer-provider contract regulations are crucial. Strong leadership, relationship-building, and strategic communication skills set top performers apart. These competencies are vital for building robust provider networks, ensuring compliance, and driving organizational growth in a competitive healthcare environment.

What does a Director of Provider Network Development do?

A Director of Provider Network Development is responsible for building, maintaining, and optimizing relationships with healthcare providers, such as hospitals and physician groups, on behalf of insurance companies or health plans. They negotiate contracts, ensure providers meet quality and cost standards, and help expand the provider network to meet organizational goals. This role often involves analyzing network performance, identifying gaps in coverage, and collaborating with internal teams to improve service delivery and member satisfaction.
What are the most commonly searched types of Provider Network Development jobs in California? The most popular types of Provider Network Development jobs in California are:
What are popular job titles related to Director Provider Network Development jobs in California? For Director Provider Network Development jobs in California, the most frequently searched job titles are:
What job categories do people searching Director Provider Network Development jobs in California look for? The top searched job categories for Director Provider Network Development jobs in California are:
What cities in California are hiring for Director Provider Network Development jobs? Cities in California with the most Director Provider Network Development job openings:
Director Provider Network Development jobs near you
Infographic showing various Director Provider Network Development job openings in California as of July 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, and 3% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution.

Director, Provider Network Management

Scripps Health

San Diego, CA

Other

Re-posted 7 days ago

Scripps Health rating

8.6

Company rating: 8.6 out of 10

Based on 141 frontline employees who took The Breakroom Quiz

9th of 887 rated healthcare providers

Job description

Location: La Jolla, San Diego

This position is eligible to participate in the Director Incentive Plan.

Founded in 1924, Scripps Health is a $5 billion, private nonprofit health system based in San Diego, founded in 1924 by philanthropist Ellen Browning Scripps. Serving over 600,000 patients annually, it operates five acute-care hospitals, 30 outpatient centers, and a wide physician network of 3,000 affiliated doctors and 17,800 employees.  Recognized nationally for excellence, Scripps has earned top rankings from Great Place to Work and Becker's Healthcare and maintains an AA rating with a stable outlook from S&P Global Ratings due to its strong leadership and financial performance.

Why join Scripps Health?

AWARD-WINNING WORKPLACE: 

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 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 2026 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.

  • Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.

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

What will you do?

  • Oversee the credentialing, provider database, contracting, and provider relations teams.

  • Lead provider relations functions, including training, problem-solving, and provider satisfaction initiatives for all medical groups, IPAs, institutional providers, and ancillary providers.
  • Be responsible for Customer Service related to both member and provider inquiries.
  • Maintain provider directories for all contracted IPAs and medical groups.
  • Support Scripps' integrated delivery system. Scripps Health Plan operates as both an MSO and a KK-licensed plan for large commercial groups.
  • Manage relationships related to Scripps Health Plan's plan-to-plan risk arrangements with major HMO plans.

Serve in a role that blends financial analysis, contract negotiations, operational efficiency, and system-wide impact, working extensively with Scripps Health Plan Services, stakeholders across the organization, and external providers and vendors. 

#LI-JS1

Required Education/Experience/Specialized Skills:

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

Preferred Education/Experience/Specialized Skills/Certification:

  • Masters degree in healthcare administration or similar

  • Epic Tapestry experience

  • Negotiation skills, creating policies and procedures and leading multiple teams.

What Scripps Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Scripps Health

Sourced by ZipRecruiter

As a nationally recognized health system, Scripps Health is committed to providing the highest quality care to our patients. Through collaboration and innovation, our healthcare professionals lead the frontier in caring for our community. With a culture centered around teamwork, each laboratory site serves as a resource of support for each other, setting our laboratories as the benchmark for standardization.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

San Diego, CA, US

Year founded

1924

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