Description Title: Associate Director, Provider Network Operations & Planning Job Type: Full-time Location: Hybrid 4 days per week in Brighton, MA office; 1 day remote FLSA Status: Exempt About Us BrightonOne is a nonpro…
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$16/hr–$19/hr
Entry level$1M raised
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Long-Term Substitute /Speech & Language Pathologist
Wilmington, Massachusetts, United States · On-site
$52/hr–$57/hr
Entry level
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Developmental/ Autism Specialist - Early Intervention
Boston, Massachusetts, United States · On-site
$56k–$68k/yr
Entry level
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About the role Supervise the delivery of high-quality residential and shared living services to the individuals receiving care by delivering training and performing quality compliance standard checks for Community Strate…
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$115k–$145k/yr
Full-time
bachelor degree, postgraduate degree
Posted 6d ago
~40 hrs/week
Responsibilities
The Associate Director leads back-office operations to ensure the accuracy, adequacy, and compliance of the provider network. This role oversees provider data management, credentialing processes, and network analytics while collaborating with leadership to drive operational efficiency.
Requirements
Candidates must have a Bachelor's degree and at least 8 years of experience in provider network operations or credentialing, including leadership roles. Proficiency in credentialing applications and knowledge of federal regulatory requirements like TRICARE or NCQA standards is required.
Location: Hybrid 4 days per week in Brighton, MA office; 1 day remote
FLSA Status: Exempt
About Us
BrightonOne is a nonprofit social enterprise delivering healthcare, housing, and hope to veterans and military-connected families, with enterprise discipline in service to those who served.
Position Overview
The Associate Director, Provider Network Operations & Planning leads the back-office operations that keep the US Family Health Plan’s provider network accurate, adequate, and compliant. Reporting to senior leadership, the role oversees provider data management, network adequacy and planning, and initial and ongoing credentialing of the provider network— including delegated credentialing, provider data, network analytics, and similar platform vendors. The Associate Director is responsible for ensuring provider data accuracy, certification and credentialing issues and concerns, and providing accurate and prompt responses to internal and external inquiries. This role collaborates closely with department leaders to evaluate and refine processes to drive operational efficiency and achievement of performance metrics and goals while maintaining compliance with regulatory requirements and accreditation standards.
Key Responsibilities
Provider Data & Credentialing Management
Oversee provider data management operations and the provider data management system, ensuring accuracy, integrity, and timeliness of provider information.
Oversee credentialing and certification operations, ensuring adherence to regulatory requirements, accreditation criteria, federal program guidelines, and internal quality standards.
Monitor, track, and report on certification and credentialing escalations to ensure timely, accurate, and compliant resolution; initiates follow-up actions and coordinates cross-functional support as needed.
Collaborate with internal teams to validate system updates, contribute to process documentation, and assist in readiness efforts for audits or accreditation reviews.
Assists in developing, compiling, and distributing routine and ad hoc reports on certification and credentialing metrics, KPIs, backlog trends, workflow timeliness, and quality indicators; contributes to presenting findings to leadership and recommending improvement strategies.
Network Operations & Planning
Support the development, review, and ongoing maintenance of provider communication materials, including notices, guides, templates, and FAQs, to ensure accuracy, clarity, and alignment with current provider data management, certification and credentialing requirements and organizational expectations.
Manage the shared inbox, ensuring triage, prioritization, and resolution of incoming requests, inquiries, and escalations within established service-level expectations.
Facilitate meetings with internal departments and external stakeholders to address certification and credentialing issues, concerns, or process dependencies, driving documentation and execution of agreed-upon action items.
Participate in and/or leads special projects, workflow assessments, and operational initiatives focused on enhancing credentialing efficiency, provider experience, and organizational compliance.
Serve as an internal resource and subject-matter expert on provider administration, provider data management and credentialing policies, workflows, systems, and best practices; provides guidance to team members and cross-functional partners as needed.
8 or more years of provider network operations, provider data, or credentialing experience, including leadership required.
2 or more years of experience working with credentialing applications and provider data management systems to support end-to-end credentialing and data workflows required.
Skills & Competencies
Working knowledge of URAC and/or NCQA accreditation standards, as well as VA, TRICARE, or other federal program regulatory requirements
Expertise in provider data management, network adequacy, and credentialing operations.
Demonstrated ability to lead teams, influence cross-functional collaboration, and translate strategy into measurable outcomes.
Ability to analyze data, prepare reports, and manage multiple priorities under deadlines.
Strong analytical, operational, and leadership skills.
Other Requirements
Must be able to obtain and maintain U.S. Government personnel security clearance as a condition of employment.
Physical Nature of the Job
Some elements of the job are sedentary, but the employee will be required to stand for periods of time or move throughout the campus.
Equal Opportunity Employer Statement
BrightonOne is an Equal Opportunity Employer. We prohibit discrimination and harassment of any kind based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, protected veteran status, or any other characteristic protected by federal, state, or local law. We strongly encourage applications from veterans and individuals with disabilities. Accommodations are available upon request for candidates taking part in all aspects of the selection process.
Work Authorization
Candidates must be authorized to work in the United States without sponsorship now or in the future.
BrightonOne provides a convenient, friendly, attractive campus in the greater Boston community for our various clinical and social service tenants.
Our mission is to serve Uniformed Service Members, Retirees, Veterans and their Families through leadership of a nationally recognized health management program providing campus based services, and developing and managing mixed income housing along with various veteran support services.
The roots of BMHC extend back to 1798, when John Adams was president and Congress was meeting for only the fifth time. The new nation’s leaders recognized that foreign trade was necessary to grow the economy and that healthy merchant seamen were needed to enable that commerce. So Congress passed “An Act for the Relief of Sick and Disabled Seamen,” which provided funding for the Marine Hospital Service.
Over time the Boston-area marine hospital moved from Boston Harbor, to Charlestown to Chelsea, before its final stop in Brighton in 1940. By then the Seamen and Sailors Act, had expanded to include funding for a greater array of community services and the Marine Hospital Service had evolved into the Public Health Service which included a network of public hospitals under its umbrella.
In 1980 the Reagan Administration decided to close many of the hospitals around the country within the public hospital system, including Brighton Marine. But the service veterans who lived in the Allston-Brighton area were not ready to let it go. They formed an organization called the Allston-Brighton Aid and Health Group and successfully petitioned the federal government to allow them to take over the property and continue medical services for veterans. That led to a new business entity in 1981 called Brighton Marine Health Center. Veterans’ care continued to be a priority, but BMHC also became a landlord on the grounds -- operating the facility and managing the property for a burgeoning list of community-oriented health care tenants.
Offices: 77 Warren Street, Brighton, Massachusetts 02135, US
Support to veterans and their familiesSupport to the local communityHealth Services - US Family Health PlanReferral Connection to Social Servicesand affordable housingHealth DiagnosticsHealth CareNon ProfitMedicalPrimary and Urgent Care
Based on 6378 listings with disclosed salaries, most healthcare jobs in Massachusetts pay between $75k–$215k per year. Individual offers vary with seniority, company size, and specialization.
How many Healthcare jobs are open in Massachusetts right now?
There are currently 21,761 open healthcare positions in Massachusetts listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Massachusetts?
Companies currently hiring include Mass General Brigham, CVS Health, UMass Memorial Health, Anna Jaques Hospital, BOSTON MEDICAL CENTER, BOSTON, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Massachusetts?
Yes — 3731 of the 21761 open healthcare positions offer remote or hybrid work (961 remote, 2770 hybrid).
How do I apply for Healthcare jobs in Massachusetts?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.