Network Operations Liaison
Personify Health
full-time
Posted on:
Location Type: Hybrid
Location: Phoenix • Arizona • United States
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Salary
💰 $95,000 - $110,000 per year
About the role
- Evaluate network capabilities: Assess Personify Health network capabilities and define clear feasibility guidelines to support client commitments, sales opportunities, and solution design.
- Lead network integration design: Design the end-to-end plan, member, and client experience as it relates to carrier and network integration, including Domestic Tier & Hospital Design structure and configuration logic.
- Serve as RFP network expert: Act as primary point of contact for all network-related RFP inputs, feasibility assessments, and design questions during sales processes.
- Coordinate cross-functional operations: Liaison between Account Management, Implementations, Data Operations, and external carrier/network partners to troubleshoot and resolve operational issues.
- Build tracking and accountability systems: Design and maintain tracking systems (consolidated Jira dashboards or automated summaries) to monitor all outstanding requests with networks, carriers, and payors across the enterprise.
- Conduct performance reviews: Lead weekly/monthly reconciliations and performance check-ins with each network/carrier/payor, managing backlogs and monitoring SLA adherence.
- Remove operational barriers: Intervene with networks to resolve aged issues, realign expectations when workflows fall behind, and connect disparate contacts within single networks to streamline communication.
- Manage escalations and SLAs: Support Account Managers and Implementation Managers in preparing escalations to brokers, clients, or carrier leadership while defining and maintaining SLA frameworks for implementations, renewals, and issue resolution.
- Drive continuous improvement: Refine processes, relationships, and workflows to continually improve network partnership efficiency and outcomes.
Requirements
- Bachelor's degree in business administration, healthcare management, or related field
- 7+ years in network operations, vendor management, or related healthcare services role
- Experience defining, managing, and enforcing SLAs with external partners
- Proven track record managing complex cross-functional initiatives and external vendor relationships with major carriers
- Deep understanding of healthcare networks and carrier operational workflows (Anthem, Aetna, UHG, Cigna structures, file exchanges, service models, escalation paths)
- Knowledge of TPA operational processes including claims workflows, eligibility exchanges, provider/network configurations, and benefit design implications
- Proficiency with EDI file formats and standards (837, 835, 834, 270/271) and ability to interpret and troubleshoot file exchange discrepancies
- Understanding of network tiering, hospital design, and benefit configuration frameworks
- Working knowledge of Jira or similar ticketing systems for consolidating cross-team workstreams
- Knowledge of legal, contractual, and regulatory requirements related to healthcare network operations
Benefits
- Competitive base salary and benefits effective day one
- Comprehensive medical and dental through our own health solutions (yes, we use what we build)
- Unlimited PTO—rest and recharge time is non-negotiable
- Mental health support, retirement planning, and financial protection
- Professional development with clear career progression and learning budgets
- Mission-driven culture where diverse perspectives drive real impact on people's health
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
network operationsvendor managementSLA managementcross-functional initiativeshealthcare networksTPA operational processesEDI file formatsnetwork tieringhospital designbenefit configuration
Soft Skills
leadershipcommunicationtroubleshootingproblem-solvingcoordinationcontinuous improvementrelationship managementaccountabilityperformance managementescalation management
Certifications
Bachelor's degree in business administrationBachelor's degree in healthcare management