Personify Health

Network Manager

Personify Health

full-time

Posted on:

Origin:  • 🇺🇸 United States

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Salary

💰 $100,000 - $120,000 per year

Job Level

JuniorMid-Level

About the role

  • Oversee a diverse portfolio of leased carrier networks and COE partners, managing ongoing performance and operational relationships
  • Drive network performance excellence by reporting on KPIs including performance guarantees, client and membership growth, network revenue, product utilization, and quality outcomes
  • Develop performance dashboards that deliver actionable insights for leadership and client account teams
  • Maintain operational oversight: develop network management documentation, prepare internal updates, manage contracts, and serve as primary contact for operational issues and processes
  • Monitor compliance: track performance guarantees, ensure accurate delivery of network scorecards, and review data for compliance with membership growth targets and claims timeliness
  • Resolve complex escalations: lead research and resolution of service requests and complex client escalations related to network issues, collaborating with networks on training coordination
  • Support strategic initiatives and GTM new network implementation with project management expertise and operational readiness coordination
  • Enable internal teams by supporting Claims Operations, Clinical teams, and Commercial teams with operational and contractual clarity
  • Organize network notification processes and contribute to the strategic development of network management capabilities

Requirements

  • Bachelor's degree in Healthcare Administration, Business, or related field (equivalent work experience considered)
  • 2-4 years experience in provider network management, provider relations, or healthcare operations
  • Experience within TPA, health plan, or health system environment
  • Demonstrated experience with different provider reimbursement models including fee-for-service
  • Understanding of value-based care concepts (ACOs, Clinically Integrated Networks)
  • Proven ability to analyze healthcare data (claims, provider, network, eligibility) to identify trends and solve problems
  • Natural ability to build rapport and establish trust with clients, providers, and internal colleagues (relationship building)
  • Strong problem-solving and analytical skills; ability to translate complex data into clear, actionable insights
  • Outstanding organizational and project management skills; ability to manage multiple projects and competing priorities
  • Exceptional written and verbal communication skills for presenting information clearly to diverse audiences
  • Self-starter who can work independently, take ownership of projects, and navigate ambiguity in dynamic environments
  • Proficient in Microsoft Office Suite (especially Excel) and comfortable learning new claims and provider management software
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