Director of Product - Network

1 hour, 53 minutes ago
Full-time
Executive
Product Management
Nomi Health

Nomi Health

Nomi Health is a healthcare services provider that supports medical testing & self insured healthcare plan administration. Become a part of the direct healthcare revolution and join our growing network of providers. You can also tap into our technology...

Insurance
251-1K
Founded 2019
$110M raised

Description

  • Define market solutions with network, go-to-market, and sales teams, including provider coverage, TPA capabilities, and integration sequencing.
  • Write detailed data-exchange requirements covering claims, pricing outputs, remittance, eligibility, file cadence, SLAs, and reconciliation.
  • Own network pricing configuration from rate-sheet ingestion through normalization, versioning, validation, effective dating, testing, release, and audit.
  • Manage provider data models and hierarchies while measuring network adequacy and directory accuracy.
  • Evaluate new group types and market segments and recommend whether they fit Nomi’s capabilities.
  • Identify payment implications of network changes and coordinate with financial services and payments teams.
  • Represent Nomi with brokers, TPA executives, and health systems while making commercially viable commitments.

Requirements

  • Hands-on understanding of billed, allowed, and paid amounts and reimbursement methodologies including fee schedules, percent of Medicare, per diem, case rate, DRG, and percent of charge.
  • Professional background in a health plan, TPA, repricing or payment-integrity vendor, reference-based-pricing administrator, provider revenue-cycle organization, or network contracting organization.
  • Experience with 837, 835, and eligibility file exchanges.
  • Ability to write integration and product requirements that engineering teams can implement successfully.
  • Experience representing solutions to brokers, TPA executives, or health systems.
  • Self-directed ability to set priorities without a predefined roadmap.
  • Technical fluency sufficient to read data models, write SQL, and provide clear engineering direction; production coding is not required.
  • Strong written communication and requirements documentation skills.
  • Preferred experience in self-funded employer healthcare, including TPA administration, direct contracting, reference-based pricing, or captives.
  • Preferred experience leading platform migrations or vendor claims-system implementations, or using automation and AI to replace manual operational work.

Interested in this position?

Apply directly on the company website

Apply Now

Similar Roles

Contract Senior Staff Product Manager (US - East)

Cobalt 251-1K Internet Software & Services

Cobalt is seeking a full-time Contract Senior Staff Product Manager to lead cybersecurity platform features and integrations from customer discovery through launch and adoption during an October–February contract.

Cybersecurity Penetration Testing
53 minutes ago

Senior Product Manager

OfficeSpace Software 251-1K Internet Software & Services

Senior Product Manager at OfficeSpace Software, an AI workplace-management company, who will turn workplace strategy, customer needs, and emerging AI capabilities into products that improve workplace insights, real estate optimization, and employee engagement.

1 hour, 23 minutes ago

Senior Product Manager, Observability Tools

ASAPP 251-1K IT Services

ASAPP is seeking a Product Manager to own simulation, evaluation, preview, and conversation-review tools that make GenerativeAgent behavior visible, testable, and trustworthy before and after production use.

Generative AI
1 hour, 37 minutes ago

Senior Product Manager – Risk Intelligence

Everbridge 1K-5K Internet Software & Services

Senior Product Manager responsible for defining and advancing Risk Intelligence products within a Critical Event Management company, helping organizations assess, monitor, and mitigate operational risks in real time.

Agile Confluence JIRA Scrum
1 hour, 37 minutes ago

You're on a roll! Sign up now to keep applying.

Sign Up

Already have an account? Log in

Used by 14,729+ remote workers