Director of Product - Network

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director of Product - Network based in United States.

This is a senior product leadership role focused on building and scaling healthcare network infrastructure that improves how claims, pricing, provider data, and payments work together.

You’ll shape market solutions from the earliest stages, ensuring network capabilities are commercially viable and operationally sound before they reach customers.

The role combines deep healthcare reimbursement expertise with product thinking, technical fluency, and strong stakeholder management.

You’ll define integration requirements, oversee network configuration and pricing workflows, and establish rigorous testing and release standards.

You’ll also make provider data, network adequacy, and directory accuracy measurable and actionable.

Working across network, sales, go-to-market, engineering, payments, and external partners, you’ll have significant ownership and autonomy.

This is an opportunity to help modernize healthcare infrastructure in a fast-moving environment where challenging conventional processes is encouraged.

Accountabilities

• Define and scope network solutions for new markets, partnering with network, sales, and go-to-market teams to assess provider coverage, TPA capabilities, integrations, and operational feasibility before commitments are made.
• Develop detailed requirements for partner and TPA data exchanges, covering claims, pricing outputs, remittance, eligibility, file cadence, service levels, reconciliation, and other critical integration requirements.
• Own the network pricing lifecycle from signed rate sheets through ingestion, normalization, versioning, effective dating, validation, testing, auditability, and production release.
• Establish standards for network configuration, pricing accuracy, testing, and release management, ensuring changes that affect reimbursement are thoroughly validated before deployment.
• Own provider data structures and hierarchies, including sponsors, tax IDs, billing NPIs, and service locations, while creating measurable processes for network adequacy and directory accuracy.
• Evaluate new customer segments and group types, determining whether they align with the platform's capabilities and confidently communicating recommendations to commercial stakeholders.
• Identify downstream payment implications of network and pricing changes and coordinate proactively with financial services and payments teams to prevent operational issues.
• Translate complex healthcare and reimbursement requirements into clear product specifications that engineering and partner teams can implement successfully.
• Work independently to identify priorities, solve operational and product challenges, and continuously improve systems through automation and technology.

Requirements

• Extensive experience in healthcare reimbursement, including practical knowledge of billed, allowed, and paid amounts and methodologies such as fee schedules, percent-of-Medicare, per diem, case rates, DRG, and percent-of-charge.
• Professional experience within a health plan, TPA, repricing or payment-integrity organization, reference-based-pricing administrator, provider revenue-cycle organization, or network contracting environment.
• Hands-on familiarity with healthcare data exchange standards, including 837 claims, 835 remittance files, and eligibility files.
• Demonstrated ability to write precise integration and technical requirements that engineering or external technology teams can successfully build from.
• Strong commercial and client-facing skills, with the confidence to represent complex network and reimbursement solutions to brokers, TPA executives, health systems, and other senior stakeholders.
• A highly self-directed approach, with the ability to define priorities, make sound decisions, and operate effectively without a pre-defined roadmap.
• Sufficient technical fluency to interpret data models, write SQL queries, understand system relationships, and provide engineers with actionable technical direction without needing to be a production developer.
• Exceptional written communication skills, particularly for requirements documents, specifications, process definitions, and cross-functional documentation.
• Preferred experience with self-funded employer healthcare, including TPA administration, direct contracting, reference-based pricing, or captive arrangements.
• Experience leading or supporting platform migrations or claims-system implementations, including managing reporting and operational challenges following migration.
• Experience as a founder, early-stage operator, or product leader who has used automation and AI to replace manual operational processes is a plus.

Benefits

• Opportunity to shape healthcare network infrastructure with direct impact on pricing, claims, provider access, and payment operations.
• Senior-level ownership and autonomy in a mission-driven, fast-moving environment.
• Cross-functional exposure spanning product, network operations, sales, go-to-market, engineering, payments, and external healthcare partners.
• Opportunity to work on complex healthcare technology challenges affecting employers, providers, payers, TPAs, and millions of people.
• Collaborative environment that encourages challenging established practices and developing better ways of working.
• Exposure to emerging automation and AI approaches for improving healthcare operations.
• Remote work environment.
• Opportunity to contribute to a growing organization focused on reducing inefficiency and improving transparency across the healthcare system.