Title : Network Product Manager
Location : Remote
Duration : FT
Summary
We are looking for a strategic and analytical Network Product Manager to lead and refine our provider network solutions with a specific focus on dispute avoidance, dispute resolution, and performance monitoring within the workers compensation bill review process. In this role, you will serve as the key liaison between internal teams, provider networks, and clients ensuring our network products are high-performing, compliant, and optimized to minimize
disputes and maximize financial and operational efficiency.
Dispute Prevention & Resolution
Develop and enforce network policies and workflows to provider reimbursement disputes related to PPO discounts, provider contracts, and post-bill review
reductions.
Analyze provider appeals and adjustments to identify trends and root causes, recommending data-driven improvements.
Collaborate with legal, clinical, and compliance teams to resolve provider disputes efficiently and consistently.
Promote proactive communication with providers to enhance understanding of reimbursement processes and reduce conflict.
Performance Measurement & Optimization
- Design and maintain network performance dashboards tracking metrics.
- Collaborate with analytics teams to evaluate network quality, effectiveness, and impact on claims outcomes. Product Development & Enhancement
Own the lifecycle of network-related solutions that enhance compliance, savings, and stakeholder satisfaction.
Translate client requirements and regulatory changes into actionable product improvements.
Monitor market and regulatory trends to guide product innovation and maintain competitive advantage.
Cross-Functional Leadership & Collaboration
- Serve as the subject matter expert on network products, provider performance, and dispute processes.
Partner with internal teams including sales, account management, RFPs, and product launches.
Collaborate with external vendors and partners
Qualifications
7-10 years of experience in Network Management and or Group Health?
Experience working in or with Bill Review disciplines
Strong written and verbal communications
Experience working in a matrixed organization and effective with multi-stakeholder management
Excellent relationship management and issue resolution skills
Enjoys managing talent at all levels; familiarity working with offshore teams a plus
Proven experience in vendor management
Excellent organizational, analytical, and communication skills.
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