Provider Lifecycle Director – Transformation

This is a fully remote position, open to applicants in United States.

📋 Description

• Define and implement a long-term strategy aimed at enhancing provider operations.

• Establish and oversee a portfolio of transformation initiatives across various provider functions.

• Identify opportunities for boosting efficiency, scalability, compliance, accuracy, and the overall provider experience.

• Develop business cases, investment plans, and metrics for success.

• Design and execute operating models across provider operation functions.

• Create workflows, governance frameworks, service models, and accountability structures.

• Streamline processes, remove redundancies, and enhance cross-functional collaboration.

• Lead initiatives focused on process redesign in areas such as Claims, Credentialing, Provider Data Management, Prior Authorization, Contracting, Delegation Oversight, and Provider Services.

• Utilize process improvement methodologies, automation, and industry best practices.

• Collaborate with Product, Technology, and Operations teams to set technology priorities and implement scalable solutions.

• Oversee the implementation of automation, AI-driven capabilities, digital intake solutions, provider portals, and workflow platforms.

• Establish key performance indicators (KPIs) and performance metrics, monitor outcomes, and ensure tangible business value and return on investment.

• Create executive reports and dashboards.

• Act as the main liaison among Provider Operations, Network Management, Clinical Operations, Technology, Analytics, Compliance, Finance, and market leadership.

• Facilitate executive governance forums and steering committees.

• Foster stakeholder alignment and promote the adoption of new processes, operating models, and technologies.

• Operate as an individual contributor.

⛳️ Requirements

• At least 8 years of experience in healthcare operations, business transformation, operational excellence, consulting, or related fields.

• A minimum of 5 years in leading large-scale, cross-functional transformation projects.

• Proven experience in redesigning operational processes and implementing improvements to operating models that yield measurable outcomes.

• Skilled in managing complex initiatives that involve multiple functions and executive stakeholders.

• Experience in developing business cases, transformation roadmaps, performance frameworks, and executive presentations.

• Background in handling initiatives related to technology, operations, and organizational change.

• Bachelor’s degree in Healthcare Administration, Business Administration, or a related discipline; four additional years of relevant experience may substitute for a degree.

• Familiarity with healthcare delivery models, provider performance management, referral management, care routing, and principles of value-based care.

• Advanced proficiency in provider operations strategy and transformation.

• Advanced skills in operating model design.

• Advanced expertise in business process improvement.

• Advanced capabilities in digital transformation and technology enablement.

• Advanced proficiency in data analytics and performance management.

• Advanced skills in organizational change management.

• Strong cross-functional leadership and influence capabilities.

• Advanced strategic planning and execution skills.

• Advanced executive communication and stakeholder management abilities.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health insurance plans.

• Generous paid time off and holiday policies.

• Opportunities for professional development and career advancement.

• Collaborative and inclusive work environment.