Director, Provider Network Management

Scripps Health•San Diego, CA

1d•Onsite

About The Position

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. 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.

Requirements

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.

Nice To Haves

Masters degree in healthcare administration or similar
Epic Tapestry experience
Negotiation skills, creating policies and procedures and leading multiple teams.

Responsibilities

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.