Director, Provider Network Management

Scripps Health

San Diego, CA

JOB DETAILS
SKILLS
Acute Care, Cardiovascular, Contract Management, Contract Negotiation, Customer Support/Service, Financial Analysis, Gastroenterology, Geriatrics, Health Maintenance Organization (HMO), Health Plan, Health Plan Membership, Healthcare, Healthcare Administration, Healthcare Providers, Hospital, Incentive Programs, JavaScript, Leadership, Negotiation Skills, Nonprofit, Obstetrics and Gynecology, Oncology, Orthopedics, Outpatient Care, Policy Development, Problem Solving Skills, Procedure Development, Provider Contracting, Provider Credentialing, Provider Relations, Relationship Management, Risk, Storage Area Network (SAN), System Integration (SI), Team Lead/Manager
LOCATION
San Diego, CA
POSTED
10 days ago

Job Description - Director, Provider Network Management (262003367)

Job Description

Director, Provider Network Management - 262003367

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

Qualifications

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.

Job

: Ops Admin

Primary Location

: Central San Diego County-SAN DIEGO-SCRIPPS HEALTH PLAN SERVICES

Work Locations

:

SCRIPPS HEALTH PLAN SERVICES

10790 RANCHO BERNARDO ROAD 4S-300

SAN DIEGO 92127

Organization

: Scripps Health Corp

Job Posting

: Jun 25, 2026, 4:51:35 AM

Benefit Status: FT - FULL-TIME WITH BENEFITS

Minimum Rate (USD)

: 72.71 -

Maximum Rate (USD)

: 105.41

In compliance with the California Pay Transparency Act, Scripps Health posts the pay range for all jobs. Please note that actual pay will be determined based on relevant experience and internal equity within the pay range. Please also note this range is applicable for employees who reside in California only. A geographical pay differential may be applied for remote employees who reside out of state. Scripps Health strives to ensure that our employees receive equal pay for equal work in line with our commitment to being an equal opportunity employer. Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.

About the Company

S

Scripps Health

Change lives. Starting with yours.

At Scripps, we're interested in people who are interested in new possibilities. People who can handle the small stuff without losing sight of the big picture. Who build bridges, not walls, knowing we can do more together than we can alone.

Here, you'll be part of a team that delivers outstanding healthcare in a supportive, respectful environment that has been repeatedly recognized as one of the nation's Top 100 Places to Work.
You'll be surrounded by people committed to making a difference in the lives of their patients and their teammates.
So if you're open to change, go ahead and open the door to possibilities.

There is no better time than now to join the Scripps Health team. Our dedication to providing a superior workplace has earned us numerous accolades, including one of the "100 Best Companies to Work For" by FORTUNE Magazine, among the "Best Employers for Workers Over age 50" by AARP, and listed among the "100 Best Employers" by Working Mother Magazine among others. We realize that our employees are our most valuable asset, so we have created a culture that offers unlimited opportunities for growth and career satisfaction.

Our history of medical excellence and community-based care spans more than 80 years. We credit our tradition of health care excellence to the dedicated individuals who make up the Scripps team. World-renowned for diagnosis, treatment and management of disease, Scripps is at the forefront of medical innovation, clinical research and technology.

  • Five hospital campuses
  • Clinic locations throughout San Diego
  • More than 2,600 affiliated physicians
  • Home health care and associated support services

We're proud of the range and quality of the benefits we offer to our employees, from massage therapy and our Scripps Wellness Program to tuition reimbursement, growth opportunities and work/life resources. There's a lot more to our benefits than your typical plan.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
FOUNDED
1924
WEBSITE
http://www.scripps.org/careers