Director of Product - Network

📋 Description

• Define and scope network solutions for new markets, partnering with network, sales, and
• Develop detailed requirements for partner and TPA data exchanges, covering claims, pricing outputs
• Own the network pricing lifecycle from signed rate sheets through ingestion, normalization
• Establish standards for network configuration, pricing accuracy, testing, and release management to
• Own provider data structures and hierarchies, including sponsors, tax IDs, billing NPIs, and
• Evaluate new customer segments and group types, determining alignment with platform capabilities

🎯 Requirements

• Extensive experience in healthcare reimbursement, including practical knowledge of billed, allowed
• Professional experience within a health plan, TPA, repricing or payment-integrity organization
• Hands-on familiarity with healthcare data exchange standards, including 837 claims, 835 remittance
• Demonstrated ability to write precise integration and technical requirements that engineering or
• Strong commercial and client-facing skills, with the confidence to represent complex network and
• A highly self-directed approach, with the ability to define priorities, make sound decisions, and

🎁 Benefits

• Opportunity to shape healthcare network infrastructure with direct impact on pricing, claims
• Senior-level ownership and autonomy in a mission-driven, fast-moving environment.
• Cross-functional exposure spanning product, network operations, sales, go-to-market, engineering
• Opportunity to work on complex healthcare technology challenges affecting employers, providers
• Collaborative environment that encourages challenging established practices and developing better
• Exposure to emerging automation and AI approaches for improving healthcare operations.