Senior Director, Provider Services

Overview

What you can expect! 

 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

 

Under the direction of the Vice President, Provider Experience, the Senior Director of Provider Services is responsible for the oversight and operational activities of the following units:  Delegation Oversight, Provider Relations, Provider Communication and Provider Operations.   The Senior Director has primary responsibility to strategize, lead, and direct the IEHP approach to the provider network system and ensures that policies and procedures are implemented for efficient, effective management of all programs. This position has overall responsibility for all aspects of the provider network system’s operational performance and is responsible for the communication and implementation of organizational initiatives to meet the strategic priorities.

 

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits

Perks

 

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary.
• Hybrid schedule.
• CalPERS retirement.
• State of the art fitness center on-site.
• Medical Insurance with Dental and Vision.
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development.
• Wellness programs that promote a healthy work-life balance.
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Key Responsibilities

Lead health plan strategy and direction related to provider and IPA support services, Delegation Oversight, Provider Relations, Provider Communication, and Provider Operations.

Drive health plan infrastructure improvements to support provider performance and health plan quality initiatives.

Oversee care delivery operations to ensure compliance with State, Federal, and NCQA policies.

Drive departmental strategic planning, including staffing, budgeting, and alignment with IEHP Strategic Priorities.

Implement best practices to increase operational efficiency and monitor performance metrics and reporting.

Establish and enforce internal and external service level agreements to measure turnaround times, quality, and program effectiveness.

Recommend operational changes and ensure implementation and adherence through structured change management processes.

Provide leadership that fosters development, integrity, mentorship, and training across departmental teams.

Build relationships with internal and external stakeholders to drive alignment with policies and norms.

Oversee IPA contract orientation and maintenance through auditing, meetings, and in-service sessions.

Coordinate onboarding and expansion of new IPAs and Delegates into Health Plan operations.

Serve as liaison with senior leadership and external partners to resolve issues and maintain partnerships.

Oversee timely communication of initiatives and changes to providers, ensuring alignment with process and technology updates.

Develop and support provider education on Health Plan requirements and enhancements.

Participate in and promote IEHP’s Mission, Vision, Core Values, LEAN principles, and Strategic Priorities, fostering engagement and collaboration across the enterprise.

Hire, train, and manage support staff, while monitoring and evaluating outcomes. Conduct performance reviews of each Team Member within IEHP guidelines.

Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Qualifications

Education & Requirements 

• Ten (10) years of progressive management and/or leadership experience in a managed care setting
• Seven (7) years of experience in leading multi-disciplinary team and/or leading cross-functional initiative/project team
• Experience with Managed Care
• Proven leadership experience, mentoring, and developing a team at a leadership level
• Demonstrated experience in a high-growth and an ambiguous environment is preferred
• Bachelor’s degree from an accredited institution required
  • Master’s degree from an accredited institution prefer