Director – Provider Transformation & Strategic Program Delivery (Healthcare Payer)

Job Title: Director – Provider Transformation & Strategic Program Delivery (Healthcare Payer)

Remote Opportunity

Position Summary:

Key Responsibilities:

• Lead execution of a $37M provider transformation program targeted for completion within the next 5 months.
• Drive enterprise-wide provider data cleanup and modernization initiatives.
• Establish delivery rigor, governance, and accountability where operational discipline is lacking.
• Partner with business, operations, technology, and provider network leaders to deliver program outcomes.
• Lead transformation initiatives spanning:
• Strategic Provider Systems
• Provider Data Management
• Provider Credentialing
• Provider Contracting (iCertis)
• Workflow Automation
• Process Simplification
• Product Ownership Models
• Manage and align 50–55 Product Owners supporting provider capabilities.
• Support national provider growth objectives and provider network expansion.
• Drive adoption of automation and digital capabilities across provider processes.
• Remove roadblocks, manage risks, and ensure milestone achievement.

Required Qualifications:

• 15+ years of healthcare payer experience.
• Extensive experience leading large-scale provider transformation initiatives.
• Strong expertise in:
• Provider Data Management
• Provider Operations
• Claims Operations
• Provider Network Management
• Contract Lifecycle Management (iCertis preferred)
• Business Process Transformation
• Demonstrated success delivering complex, enterprise-wide programs under aggressive timelines.
• Strong execution mindset; hands-on leader who drives outcomes rather than provides advisory support.
• Exceptional communication and executive stakeholder management skills.

Preferred Qualifications:

• Experience managing provider organizations with 100,000+ providers.
• Experience building automation and digital transformation roadmaps.
• Agile Product Ownership and Product Management experience.
• Experience operating in highly matrixed healthcare organizations.