Director, network operations work from home jobs - 501 jobs
Remote Channel Growth Director - Networking & SD-WAN
Expereo International
Remote job
A global connectivity solutions provider is seeking a Channel Sales Manager in Chicago. The role involves driving revenue growth through partnerships and managing day-to-day relationships with Technology Solution Distributors. Candidates should have 5-8 years of sales experience, preferably in telecommunications or enterprise technology, with strong communication and relationship-building skills. This position offers a competitive health care plan, 401k retirement plan, and the option to work from home.
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$94k-131k yearly est. 23h ago
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Remote Channel Growth Director - Networking & SD-WAN
Expereo
Remote job
A leading global connectivity provider is seeking a Channel Sales Manager to enhance revenue growth through established partnerships. The ideal candidate will have 5-8 years in sales, focusing on channel sales management, and will be responsible for managing partner relationships to maximize sales effectiveness. Strong skills in Salesforce and a background in telecommunications or networking technology are required. This role offers competitive benefits including health care and a retirement plan. Remote work options are available.
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$94k-131k yearly est. 23h ago
Director of Automation & Operational Excellence (Remote)
Unitedhealth Group 4.6
Remote job
A leading healthcare company is seeking a Director - Automations & Efficiencies to lead innovative projects aimed at enhancing operational effectiveness. This role involves overseeing automation initiatives in a healthcare environment, managing strategic partnerships, and improving processes through advanced technologies. The ideal candidate has significant experience in healthcare payer operations, RPA technologies, and cross-functional leadership. This position offers flexibility to work remotely from anywhere within the U.S.
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$97k-116k yearly est. 1d ago
Director, Provider Network Performance
Castlight Health 4.7
Remote job
apree health is seeking an experienced leader to oversee the operations and performance of our medical network to ensure success in value-based partnerships.
How will you make an impact & Requirements
that can be based anywhere within the United States.**
We are seeking an experienced and outcomes-oriented Director, Partner NetworkOperations & Performance to oversee the operational and clinical performance of our contracted provider partners.
This leader drives execution on economic, clinical, and population health strategies that enable success under value-based care arrangements. This role requires deep familiarity with provider risk contracts, including understanding the economic levers and operational dynamics necessary to optimize performance in shared savings, capitation, or full-risk arrangements.
This position leads efforts to proactively pull, analyze, and translate population health data into strategic insights, identifying opportunities for improvement and partnering with providers to create and execute actionable plans that enhance quality, reduce cost, and improve patient outcomes.
The Director is accountable for fostering healthy relationships with partner practices, alignment to Vera's clinical and operational model, and support for the Population Health Analyst and Clinical Liaison, who together enable providers to deliver on population health outcomes.
Key Responsibilities:
Risk-Based Operational Oversight
Lead and support partner practices under value-based care/risk contracts, ensuring performance against key financial and quality metrics.
Develop deep understanding of contract terms, attribution, quality incentive structures, and risk adjustment methodologies.
Translate contract details into operational execution strategies for practice teams.
Population Health and Data Strategy
Establish and maintain a predictable cadence of population health data pulls and reviews in collaboration with the Population Health Analyst.
Guide analysis and interpretation of population health trends, patient segmentation, care gap closure, and cost utilization data.
Drive the development of actionable plans with clinical and operational teams based on identified opportunities in the data.
Monitor implementation progress and iterate strategies to improve results.
Cross-Functional Team Leadership
Directly manage and develop the Population Health Analyst and Clinical Liaison, ensuring they have clear priorities, training, and performance goals aligned to Vera and partner practice objectives.
Serve as a liaison between clinical,operational, and analytical teams to ensure data-driven decisions inform daily workflows and strategic initiatives.
Partner Practice Relationship Management
In partnership with the Sr. Manager, Provider Network Success, build and maintain high-trust relationships with partner practice leadership teams, serving as a strategic advisor and performance coach.
Facilitate regular Joint Operating Committees or similar governance forums with provider partners and internal stakeholders.
Identify partner needs and tailor apree support resources accordingly to meet mutual goals.
Lead quality improvement initiatives focused on closing care gaps, enhancing patient experience, and optimizing clinical workflows.
Collaborate with internal stakeholders to support the expansion or onboarding of new partner practices.
Required Education and Experience:
Bachelor's degree in Healthcare Administration, Public Health, Business, or related field.
Minimum 5 years of leadership experience in healthcare operations, preferably in value-based or risk-based care settings.
Strong understanding of provider risk contracts, including upside/downside risk, capitation, and shared savings models.
Experience managing multi-site healthcare operations and cross-functional teams.
Demonstrated experience in population health management, data interpretation, and performance improvement.
Preferred Qualifications:
Master's degree in Business, Healthcare Administration, Public Health, or similar preferred.
Experience working with ACOs, CINs, or delegated provider groups under risk.
Certified clinical background (e.g., RN, NP, PA) is a plus.
Experience leading virtual teams across regions/states.
Strong proficiency in Excel and healthcare analytics tools.
Key Competencies:
Strategic thinker with strong analytical acumen and ability to translate data into action.
Clear and persuasive communicator with ability to influence providers and stakeholders.
Strong project management and organizational skills.
Demonstrated commitment to patient-centered, value-based care.
Comfort working in a fast-paced, evolving environment with changing contract and partner dynamics.
Work Environment & Travel Requirements:
Remote with regional travel to partner practices as needed (up to 50%).
May require occasional evening or weekend hours.
Must be able to work with team members across time zones and virtual platforms.
**This position is bonus eligible based on individual and company performance.**
Compensation:
$170,616.00
to
$213,270.50
$170.6k-213.3k yearly Auto-Apply 30d ago
Director of Network Business Development
N-Power Medicine
Remote job
About N-Power MedicineN-Power Medicine aims to establish a new paradigm in drug development by reinventing the ‘how' and transforming clinical trials through better integration with clinical practice, ensuring broader participation by physicians and patients. We are building an exceptional multi-disciplinary team with diverse expertise spanning healthcare, engineering, technology and regulatory, and with people who share our core value of Empowering Community through generosity, curiosity and humility. We are working with urgency to uniquely enable community oncology practices to become high-performing clinical trial centers, enabling a new ecosystem that brings better therapies to patients faster than ever before.
Position OverviewHead of Network Business Development will report to the Head of Network Services and be a critical member of N-Power Medicine's Network Leadership Team. They will provide leadership and direction of N-Power's execution for building a large community cancer network utilizing the N-Power Platform with a goal of achieving a Network scale of over 100 sites and 20 logos by 2028. The overriding responsibility of this leader will be to recruit new practices to the N-Power network.
This leader will be a dynamic sales executive who can present a compelling vision for why a variety of healthcare providers should embrace joining the Network. The leader will be comfortable communicating with physician and research leadership in oncology practices as well as C-suite executives spanning legal, IT, compliance, within large and complex integrated healthcare networks.
The candidate demonstrates the ability to thrive and deliver results in a fast paced environment. The candidate will be expected to remain closely aligned with the evolving strategy of the pharma facing business development team to ensure the strategy and goals and needs of the pharma customers can be met by the growing scale and capabilities of the physician network. Finally, collaborating across the organization, the candidate will participate in the development of strategic and tactical plans to achieve the corporation's goals and objectives.
This is a remote position within the United States with intermittent in-person team meetings and travel to key customer or potential customer sites.
Role Objectives and Responsibilities-Lead with a focus of sourcing, meeting, and recruiting new sites and logos to join the N- Power Network. -Collaborate with the Head of NetworkOperations and Medical Affairs to align on refining and articulating the value proposition of the N-Power Platform to the prospective Network sites.-Collaborate with the Head of NetworkOperations and Medical Affairs to ensure the smooth on-boarding of the new logos towards full implementation of the N-Power Platform. -Develop strategic partnerships with various organizations that offer an opportunity to connect with prospective customers who reside in the community cancer center ecosystem.-Understand the needs of the health systems that have Network practices in terms of key accreditation, strategic initiatives, or operational challenges for which N-Power is well positioned to provide critical assistance.-Work closely with the CMO, and physicians on the Clinical Science team, as well as leaders in Clinical Operations, VPP services, DHS services, Medical Affairs, and NetworkOperations to aid in recruiting opportunities when necessary. -Assist in the vetting and recruitment of additional selected positions in the Network Service organization.-Work closely with Pharma facing commercial team and company leadership on forecasting future growth targets of the Network.-Participate in the development of enabling technologies and services that will increase the value of the Network to prospective practices considering joining the N-Power Medicine Network. -Represent N-Power Medicine externally at conferences.-Foster effective cross-functional collaboration by promoting open communication, knowledge sharing, and teamwork.-Other activities as they may be assigned.
Education, Experience, Behavioral Competencies & Skills-6+ years experience in sales in healthcare, ideally in community oncology network facing activities plus 3+ years managing a sales team preferred. -Bachelor's degree preferred.-Proven track record of opening new markets and building a larger funnel across a variety of archetypes or sales channels.-Experience working with highly integrated teams.-Experience working with a CRM.-Excellent leadership and people management skills, with a demonstrated ability to build and motivate high-performing teams.-Strong communication and presentation skills, with the ability to convey complex information to healthcare leaders and physicians.-Ability to work effectively in a fast-paced and dynamic environment, managing multiple priorities simultaneously.-Generous, Curious & Humble.
Travel Requirements ● Up to 30% of time required to travel in role Pay InformationThe expected salary range for this position is $180,000 and $200,000. Actual pay will be determined based on experience, qualifications, geographic location, and other job-related factors permitted by law. N-Power Medicine (NPM) offers equity at hire as well as a discretionary annual bonus which may be available based on Company performance. This position is eligible for company benefits.
About Us:We are a mission-driven, well-funded, rapidly growing company, eager to attract passionate professionals offering a highly attractive compensation package with a balanced and flexible work environment, competitive industry benefits as well as a 401K plan and other great company “perks.”
We are an Equal Opportunity Employer and value diversity at our company. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Please note that state-specific background checks and screenings may be required for this role. Employment is contingent upon successfully passing all applicable screenings.
Applicants must be currently authorized to work in the U.S. on a full-time basis. The Company will not sponsor applicants for work visas.
Notice on fraudulent job offers: Only positions posted on ****************************************** site are legitimate. Please be mindful of recruitment fraud and job scams.
$180k-200k yearly Auto-Apply 49d ago
Director of Network Automation Training
Netbrain 4.0
Remote job
Founded in 2004, NetBrain is the leader in no-code network automation. Its ground-breaking Next-Gen platform provides IT operations teams with the ability to scale their hybrid multi-cloud connected networks by automating the processes associated with Diagnostic Troubleshooting, Outage Prevention and Protected Change Management. Today, over 2,500 of the world's largest enterprises and managed services providers leverage NetBrain's platform.
What We Need
We are seeking an experienced and strategic Director,Network Automation Training to lead the enablement initiatives for both NetBrain's internal teams and external customers. This leadership role will be responsible for translating our no-code automation platform innovations into actionable knowledge, ensuring both our customer engineers and internal teams are fully equipped to maximize the platform's value.
As the Director, you will develop and execute enablement strategies that drive adoption, create efficiencies, and enhance the overall experience for customers and internal stakeholders. You will work closely with Product, R&D, and Customer Success teams to ensure seamless knowledge transfer and skill development.
What You'll Do
You will develop and drive a comprehensive enablement strategy for both internal teams and external customers, ensuring successful adoption of NetBrain's no-code automation platform.
Create and execute scalable training programs to empower customer engineers to build their own automation solutions.
Design and implement a tiered customer enablement framework, addressing the needs of End Users, Power Users, and Super Users through a mix of web-based, in-person, and self-guided learning methodologies.
Lead the initiative to translate product innovations from R&D to customer-facing teams, ensuring technical advancements are effectively communicated and operationalized.
Work closely with Product, Engineering, Sales, and Customer Success teams to align enablement strategies with business goals and drive customer success.
Establish key performance indicators (KPIs) to measure the effectiveness of enablement programs and continuously optimize strategies based on data-driven insights.
Who You Are
You have 10+ years of experience in customer enablement, technical training, or product enablement, with at least 5 years in a leadership role.
Strong understanding of enterprise networkoperations.
Proven track record of developing and executing large-scale enablement strategies for both internal teams and external customers.
Exceptional ability to translate complex technical concepts into digestible, actionable learning materials.
Strong analytical mindset with experience in defining and measuring enablement success.
Excellent communication and presentation skills, with the ability to engage both technical and non-technical audiences.
What We Offer
Our comprehensive compensation package is vital in how we recognize our people for the impact they make on us reaching our goals as a company.
For this role, the estimated base salary range is between $165,000 - $200,000 + Bonus. The actual salary may vary based on a range of factors, including market and individual qualifications objectively assessed during the interview process.
The range listed above is a guideline, and may be modified. People Experience offers a comprehensive benefits package in addition to cash compensation that includes, but is not limited to, 401k and medical/dental coverage. Speak with your Recruiter for more details on our Total Rewards philosophy.
NetBrain invites all interested and qualified candidates to apply for employment opportunities.
Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or other characteristics protected by law.
If you have a disability that prevents or limits your ability to use or access the site, or if you require any other accommodation in the application process due to a disability, you may request a reasonable accommodation. To make a request, please contact our People Team at: *********************** and we will be happy to assist you.
In compliance with applicable laws, NetBrain conducts holistic, individual background reviews in support of all hiring decisions.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
$123k-164k yearly est. Auto-Apply 41d ago
Director, NSC Networks (Internal Applicants Only)
National Safety Council 4.0
Remote job
Save lives, from the workplace to anyplace. The National Safety Council is America's leading nonprofit safety advocate. We focus on eliminating the leading causes of preventable injuries and deaths. Through leadership, research, education, and advocacy, NSC focuses on areas where most unintentional injuries and deaths occur.
We are currently looking for a Director, NSC Networks to join us in our mission to save lives and prevent injuries.
Position Highlights:
This is a unique opportunity to spearhead a dynamic team of tenured EHS professionals, amplify member engagement, and forge lasting network connections. Join us in the role of Senior Director, where you will assist corporate members in the advancement of their EHS programs, coordinate with fellow EHS professionals and share knowledge cutting-edge global EHS programs and techniques.
Picture this: You, at the helm of NSC Networks, leading EHS activities that not only attract and retain members but also nurture relationships that help enhance their EHS programs and protect their employees and the environment .
But it doesn't stop there! Your expertise in Health, Safety, and Environment (HSE) leads the team, and informs the broader National Safety Council to setting world-wide professional standards in excellence.
So, if you're a trailblazer with a knack for weaving harmony amidst complexity, a leader to deliver unparalleled member satisfaction, and a technical expert in HSE, then step onto this stage. The spotlight awaits - are you ready to lead the way?
What You'll Do:
Lead the NSC Networks team, including Campbell Institute, to continue to drive collaboration, innovation, and a customer-centric approach.
Develop and implement a comprehensive and innovative strategy that aligns with the company's growth objectives and market trends.
Develop and maintain NSC Network customer offering, inclusive of Campbell Institute, that aligns and is coordinated with the overarching NSC Membership offering.
Lead networking meetings and serve as the face and center of excellence of the group.
Maintain and expand a strong team of H&S SME's who can foster deep relationships and support for the membership.
Analyze and optimize customer-centric processes for a deep networking experience, implementing improvements, and prioritizing the members' needs.
Collaborate with members and cross-functional teams to develop and implement H&S projects that will drive health and safety in all workplaces.
Create a strong relationship between NSC Networks, Campbell Institute, Consulting & Assessments, and Membership that will coordinate peer-reviewed research, policy work, and tools for organizations to deploy.
Represent the company as an EHS leader, ensuring alignment with senior executive(s) and programmatic teams.
Have responsibility for the P&L of the NSC Networks with a growth mindset.
Identify global Health, Safety, and environmental issues, and lead compliance strategies.
Collaborate with the shared service teams to streamline and clearly communicate support services requirements necessary for running the NSC Networks.
Continuously gather competitive insights and analyze member needs to incorprate into informed decision-making and strategic planning.
Lead cross-functional initiatives prioritized by the Executive Leadership Team, driving collaboration and execution.
Create and conduct presentations and updates for stakeholders and members on special projects, representing the company in industry events and conferences
We're Looking for Someone with:
Master Degree in EHS, engineering or a closely related field.
Minimum of 10 years of relevant HSE experience.
Experience at a corporate/regional level is strongly preferred.
CIH and/or CSP certification.
Proven work experience as a leader of EHS programs at the senior manager or director level.
Global experience implementing and developing EHS programs.
Excellent communication, leadership, and interpersonal skills, with the ability to build strong relationships and influence outcomes.
Strategic and analytical thinking, with a focus on data-driven decision-making and problem-solving.
Proven ability to drive results, manage priorities and allocate time effectively, with limited guidance and direction.
Demonstrable experience making decisions within guidelines and policies that impact business performance and growth.
Ability to identify and challenge guidelines and policies that do not add value to support the overall mission.
This is a remote position with travel.
Salary for this role is $202,000
This role is open to internal applicants at this time.
Reasons You'll Love it here:
NSC cares about the safety, health, and overall well-being of our employees. We offer competitive benefits, resources, and tools to promote a work-life balance that supports employees during all phases of life. We offer the following:
At least 20 PTO days accrued 1
st
year and 11 paid holidays
Flexible work arrangements
Comprehensive medical, dental, vision, and life insurance plans
Flex spending accounts for medical and dependent care
403(b) & Roth 403(b) with employer match up to 6%
Reimbursable training
Dress for your day
Our hiring process is designed to give you the opportunity to shine at each step. It starts with an assessment where you really showcase your drive for the role. From there, candidates selected for the first interview will discuss their skills and how they fit with our team. If you're a match, the second interview takes a deeper dive into your background and how you can contribute to our goals. After that, we'll make our final decision and let you know the outcome. This is our usual process, and we're excited to get to know you along the way!
NSC is a Recovery-Friendly Workplace.
We support individuals in or seeking recovery from substance use disorder by fostering a culture of respect, inclusion, and support. We provide access to confidential resources, reasonable accommodations, and a work environment that values your journey and contributions.
NSC is an equal opportunity employer.
$202k yearly Auto-Apply 35d ago
Director, Operations Portfolio and Planning
College Board 4.6
Remote job
Director,Operations Portfolio & Planning
College Board - Operations
Role Type: This is a full-time position
About the Team
College Board Operations Division is a best-in-class digital assessment delivery and customer engagement function that supports millions of students and thousands of test centers, annually. The Operations team is leading exciting work to advance customer experience using innovative solutions, emerging technologies, and integrated products to enhance the end-to-end delivery of digital assessments and all aspects of customer support.
The Knowledge, Learning & Operational Effectiveness team collaborates across all operational functions to design and deliver integrated solutions that power our core operations. Our mission is to create a connected ecosystem that supports College Board digital experiences, enabling operational efficiency and exceptional customer outcomes. From backend systems to educator-facing content, every solution we deliver is purposefully crafted to enhance the customer journey, ensuring seamless, intuitive, and impactful interactions at every stage.
About the Opportunity
As the Director,Operations Portfolio & Planning, you will create and lead a centralized portfolio management and planning capability within Operations. You will develop and maintain a single, integrated view of all operational initiatives, both the work Operations leads and the support required for product and program delivery, to ensure alignment, prioritization, and sequencing across teams and release cycles.
Working in partnership with Product, Program, Technology, and Operations leaders, you'll provide a single point of engagement and a unified “One Ops” view for roadmap integration ensuring Operations keeps pace with product timelines and launches. You'll ensure that Operations designs complete, connected solutions for how work gets done. This includes establishing clear pathways for automation and technology solution requests through a single, visible intake point that connects Operations to Technology and enables scalable, reusable solutions.
You'll drive the operational rhythm of the business by coordinating planning activities, creating transparency into priorities, dependencies, and ownership across Operations. As a spokesperson for Operations, you will represent the portfolio to internal and partner audiences communicating our collective roadmap, priorities, intended outcomes and advocating for shared wins with clarity and confidence.
In this role, you will:
Planning, Prioritization & Operational Rhythm (40%)
Lead planning strategies that shape the priorities for Ops internal platforms & product integration
Establish planning cadences across Operations supporting continuous intake, prioritization, and delivery routines that bring structure and predictability to how work flows.
Create transparency into work in progress and dependencies across Ops teams.
Manage the rhythm of execution by running internal reviews, surfacing blockers, escalating risks, and ensuring on-time delivery.
Communicate clearly with leaders and stakeholders on what is moving forward, when, and why.
Portfolio Strategy Integration & Roadmap Alignment (30%)
Work with stakeholders to maintain a consolidated view of product and program initiatives that intersect with operational initiatives, activities, and functions.
Organize engagements to ensure Operations' portfolio needs are captured. Facilitating Operations leaderships prioritization of features with robust analysis. And guiding efforts to ensure planning alignment between Operations, Product, Program, and Technology teams.
Ensure Ops delivery milestones are fully aligned with product launch timelines so the front stage and backstage stay in sync.
Establish an Ops cross-portfolio approach to analyze, document and deliver analytic insights and data that influence product and service design.
Support the evolution of Ops' Knowledge Management (KM) systems and learning development by maintaining team visibility on emerging and future operational systems and requirements.
Solution Enablement (30%)
Establish and manage a single intake process for technology solution requests, ensuring visibility and consistency across to deliver scalable solutions that improve efficiency.
Track and communicate the outcomes and impact of delivered solutions, using data to inform future prioritization decisions.
Advocate for Operations' portfolio priorities with stakeholders, identifying win-win opportunities to improve existing systems and ensuring new systems are ready to meet the unique needs of Operations and the customers it serves.
About You
7+ years of experience in operations planning, portfolio management, or product/program management within a complex, matrixed organization.
Strong understanding of product development and technology delivery lifecycles, with the ability to translate operational needs into clear, actionable work for technical teams.
Demonstrated success partnering with Product, Program, and Technology leaders to align goals, identify dependencies, and deliver complete, scalable solutions.
Highly comfortable operating in ambiguity: you can start from a blank slate, make sense of scattered inputs, and shape structure where none exists. You adapt quickly as new information surfaces and see ambiguity as an opportunity, not a blocker.
A collaborative, low-ego teammate who builds trust across diverse groups. You naturally work through influence rather than authority, and you're energized by shared ownership, joint problem-solving, and helping others succeed.
Exceptional organization and prioritization skills, with the ability to move multiple projects forward independently and collaboratively.
Strong analytical and problem-solving skills, using data to inform prioritization, assess impact, and measure delivery outcomes.
Excellent verbal and written communication skills, including facilitating planning sessions, leading reviews, and presenting to senior leadership.
Proven ability to influence and build relationships across diverse teams, bringing structure without adding bureaucracy.
Ability to travel 6-8 times a year to College Board offices or on behalf of College Board business.
All roles at College Board require:
A passion for expanding educational and career opportunities and mission-driven work
Curiosity and enthusiasm for emerging technologies, with a willingness to experiment with and adopt new AI-driven solutions and comfort with learning and applying new digital tools independently and proactively.
Clear and concise communication skills, written and verbal
A learner's mindset and a commitment to growth: welcoming diverse perspectives, giving and receiving timely, respectful feedback, and continuously improving through iterative learning and user input.
A drive for impact and excellence: solving complex problems, making data-informed decisions, prioritizing what matters most, and continuously improving through learning, user input, and external benchmarking.
A collaborative and empathetic approach: working across differences, fostering trust, and contributing to a culture of shared success
Authorization to work in the United States
About Our Process
Application review will begin immediately and will continue until the position is filled. This role is expected to accept applications for a minimum of 5 business days.
While the hiring process may vary, it generally includes: resume and application submission, recruiter phone/video screen, hiring manager interview, performance exercise such as live coding, a panel interview, a conversation with leadership and reference checks.
What We Offer
At College Board, we offer more than a paycheck- we provide a meaningful career, a supportive team, and a comprehensive package designed to help you thrive. We're a self-sustaining nonprofit that believes in fair and competitive compensation grounded in your qualifications, experience, impact, and the market.
A Thoughtful Approach to Compensation
The hiring range for this role is $80,000-$135,000.
Your exact salary will depend on your location, experience, and how your background compares to others in similar roles at the College Board.
We aim to make our best offer upfront, rooted in fairness, transparency, and market data.
We adjust salaries by location to ensure fairness, no matter where you live.
You'll have open, transparent conversations about compensation, benefits, and what it's like to work at College Board throughout your hiring process. Check out our careers page for more.
#LI-REMOTE1
#LI-AP1
$80k-135k yearly Auto-Apply 14d ago
Director, Network Development
Magellan Health 4.8
Remote job
This position is responsible for the development of the provider network, assuring network adequacy and appointment access, development of network resources in response to unmet needs, and adequacy of the provider network to provide member choice of providers, and contracting with qualified service providers in compliance with federal and state laws. This role will lead Magellan's strategy and planning in the successful development of the provider network including network development, contracting, credentialing and provider communications for existing or emerging markets, as assigned. Role is responsible for the annual network development plan as well as key business development activities as assigned.
Leads network planning and strategy efforts to support the successful implementation or transformation of the various delivery systems, including assisting in all network related activities during new contract implementations
Conducts market research for emerging markets and develops Capture Strategy specific to the provider network - SWOT Analysis of each Tier 1 Priority State specific to the current provider delivery system as applicable.
Operates as a Network SME for all active proposals, work with the existing national network team to drive solutions, actively storyboard solutions to identified problems, and assist in preparing content post RFP release.
Travel to identified opportunity, facilitating meetings in the market with providers, provider associations etc. and develop comprehensive summaries of all provider engagement as needed
Contribute to comprehensive work plans geared towards understanding the Network, building out a comprehensive list of all provider types including training, qualifications, and cost requirements.
Plans, develops and ensures implementation and positive outcomes of the Annual Network Development Plan including network adequacy and appointment access, development of network resources in response to unmet needs, contracting with qualified service providers and compliance with Federal and State laws.
Leads and provides direction to the Magellan Network team including all development responsibilities.
Leads provider recruitment activities and ensures compliance with contracting, credentialing and privileging policies and procedures.
Ensures the Network Transition Plan is successful meeting all established timeframes.
Other network related activities as assigned.
The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.
Other Job Requirements
Responsibilities
8+ years managed healthcare experience.
Significant experience in progressive network management and development. Knowledge of NCQA requirements.
General Job Information
Title
Director,Network Development
Grade
30
Work Experience - Required
Network
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelor's
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$105,230
Salary Maximum:
$178,890
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Director, Technology Financial Operations (FinOps) DEPARTMENT: Technology REPORTS TO: VP, Business of Technology FLSA STATUS: Salaried, Exempt
LEGENDS GLOBAL Legends Global is the premier partner to the world's greatest live events, venues, and brands. We deliver a fully integrated solution of premium services that keeps our partners front and center through our white-label approach. Our network of 450 venues worldwide, hosting 20,000 events and entertaining 165 million guests each year, is powered by our depth of expertise and level of execution across every component feasibility & consulting, owner's representation, sales, partnerships, hospitality, merchandise, venue management, and content & booking of world-class live events and venues. The Legends Global culture is one of respect, ambitious thinking, collaboration, and bold action. We are committed to building an inclusive workplace where everyone can be authentic, make an impact, and grow their career. Winning is an everyday thing at Legends Global. We have the best team members who understand every win is earned when we come together as one unified team. Sounds like a winning formula for you. Join us!
THE ROLE
The Director, Technology Financial Operations is a senior leader within the Technology organization responsible for providing financial stewardship,operational oversight, and cost transparency across all Technology spend. This role partners closely with Technology leadership, Accounts Payable, Procurement, and Finance to ensure Technology budgets, vendor costs, and recharge models are accurately represented and aligned with enterprise standards.
The Director oversees budgeting support, spend visibility, cost allocation, and recharge governance, ensuring Technology costs are properly tracked, validated, and distributed across venues and business units. This individual combines strong analytical skills with operational rigor, enabling Technology to operate with clarity, accountability, and financial discipline while maintaining a collaborative relationship with Finance.
ESSENTIAL DUTES AND RESPONSIBILITIES
Budgeting & Spend Stewardship
• Partner with Technology leadership to support the annual budgeting process, quarterly forecasts, and periodic spend reviews.
• Provide Technology leaders with clear visibility into spend trends, variance drivers, and potential risks or opportunities.
• Monitor Technology operating and project spend across categories to ensure alignment with approved budgets and organizational priorities.
Invoice Management & AP Coordination
• Oversee Technology's invoice intake, validation, coding, and routing to ensure timely processing and accurate classification.
• Serve as the primary liaison between Technology and Accounts Payable to resolve invoice discrepancies, vendor issues, or workflow challenges.
• Improve consistency and accuracy in invoice handling by establishing standardized templates, processes, and coding guidelines.
Cost Allocation & Recharge Governance
• Maintain and enhance Technology's cost allocation and recharge frameworks, ensuring costs are appropriately distributed to venues and business lines.
• Identify inaccuracies, under-recharging, and gaps in cost distribution and implement corrective actions in partnership with Technology leadership.
• Align with Finance to ensure recharge methodologies and allocation practices adhere to enterprise guidelines and accounting principles.
Cross-Functional Partnership
• Partner with Procurement, Legal, and vendor managers to ensure contractual commitments, renewals, and SOWs are aligned with budget expectations.
• Collaborate with Finance to validate cost alignment and ensure Technology's spend is accurately reflected in enterprise reporting.
• Work with Technology tower leads to support cost tracking for hardware, software, licensing, services, and vendor contracts.
Financial Reporting & Analysis
• Develop internal dashboards, summaries, and analyses to provide Technology leadership with actionable insights into spend, allocations, and recharge impacts.
• Create and maintain financial models that improve visibility into run-rate costs, vendor spend, and budget utilization.
• Present regular updates to Technology leadership on budget status,operational impacts, and recharge accuracy.
Process Governance & Continuous Improvement
• Establish governance frameworks, approval workflows, and documentation to improve spend management, invoice processing, and allocation practices.
• Lead continuous improvement initiatives to streamline workflows, reduce manual effort, and increase cost visibility across Technology.
• Ensure compliance with internal controls, audit requirements, and organizational policies related to spend and budgeting.
SUPERVISORY RESPONSIBILITIES
Carries out supervisory responsibilities in accordance with all Legends Global policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty with energy and enthusiasm. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Required
• 8+ years of experience in Technology Financial Operations, Technology Business Management (TBM), Technology Business Partnering, FP&A-adjacent roles, or similar operational leadership functions.
• Strong analytical and financial modeling skills, with advanced Excel proficiency.
• Experience working with large budgets, cost allocation methods, recharge models, or multi-entity cost distribution.
• Demonstrated ability to collaborate across Technology, AP, Procurement, and Finance teams.
• Strong vendor management and invoice oversight experience.
• Excellent communication skills, with the ability to explain financial concepts to non-financial stakeholders.
• Strong organizational skills and the ability to manage complexity in a fast-paced environment.
Preferred
• Experience in multi-venue, multi-entity, or large enterprise environments.
• Familiarity with Technology Business Management (TBM), cost transparency models, or Technology financial governance practices.
• Experience improving financial processes or implementing spend management best practices.
EDUCATION AND/OR EXPERIENCE
• Bachelor's degree required in Business Administration, Information Systems, Technology Management, Accounting, Finance, or a related field.
• 8+ years of progressively responsible experience in Technology Operations, Technology Business Management (TBM), Technology Financial Operations, Business Partnering, FP&A-adjacent roles, or similar financial/operational leadership functions.
• Demonstrated experience managing Technology budgets, vendor spend, or large operational cost centers within a complex or multi-entity organization.
• Prior experience coordinating with Accounts Payable, Procurement, and Technology leaders on invoice workflows, cost tracking, budgeting, or vendor financials.
• Experience developing or maintaining cost allocation, chargeback, or recharge models strongly preferred.
• Experience working in a large enterprise, multi-venue, or multi-business-unit environment strongly desired.
• Strong analytical background with proven ability to interpret spend data, identify trends, and translate insights into recommendations.
• Advanced Excel or financial modeling skills required; experience with spend analytics tools or TBM frameworks is a plus.
• Prior leadership experience managing processes, programs, or cross-functional initiatives; people management experience preferred but not required.
SKILLS AND ABILITIES
Strategic & Analytical Skills
• Strong analytical and problem-solving skills with the ability to interpret complex spend data and translate findings into actionable recommendations.
• Ability to develop clear financial insights, forecasts, and spend visibility models for Technology leadership.
• Demonstrated capability to identify inefficiencies, under-recharging, or cost discrepancies and drive corrective action.
Operational & Process Excellence
• Strong understanding of Technology operational cost structures, vendor spend, and budgeting practices.
• Proven ability to build, document, and improve processes related to invoice management, spend tracking, and cost allocation.
• Ability to create structure in ambiguous environments and establish sustainable governance frameworks.
• Demonstrated experience managing high-volume workflow processes with accuracy and timeliness.
Cross-Functional Collaboration
• Ability to partner effectively with Technology, Accounts Payable, Procurement, Vendors, and Finance teams while maintaining clear ownership boundaries.
• Skilled at building trusted relationships with senior leaders and communicating clearly across technical and non-technical audiences.
• Strong negotiation and influence skills, especially when navigating cross-departmental priorities.
Communication & Leadership
• Excellent written and verbal communication skills, including the ability to prepare clear summaries, dashboards, presentations, and updates for leadership.
• Ability to explain financial and operational concepts in straightforward language that non-financial stakeholders can understand.
• Confident leadership presence with the ability to guide stakeholders, establish expectations, and drive accountability.
Technical & Tooling Proficiency
• Advanced Excel skills required (formulas, pivot tables, modeling).
• Ability to work with spend analytics tools, invoice systems, or reporting platforms.
• Strong aptitude for learning new systems and tools quickly, particularly those used for budgeting, invoice routing, or cost tracking.
Professional Attributes
• High attention to detail and accuracy in all aspects of spend and cost tracking.
• Strong organizational and prioritization skills, with the ability to manage multiple deliverables in a fast-paced environment.
• Demonstrated sound judgment, discretion, and the ability to maintain confidentiality when handling sensitive financial and vendor information.
• Proactive, self-starting, and able to operate independently while maintaining alignment with leadership.
COMPENSATION
Competitive salary, commensurate with experience, and a generous benefits package that includes medical, dental, vision, life and disability insurance, paid vacation, and 401k plan.
WORKING CONDITIONS
Location: Remote
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
NOTE:
The essential responsibilities of this position are described below the above headings. They may be subject to change at any time due to reasonable accommodation or other reasons. Also, this document in no way states or implies that these are the only duties to be performed by the employee occupying this position.
Legends Global is an Equal Opportunity/Affirmative Action employer, and encourages Women, Minorities, Individuals with Disabilities, and protected Veterans to apply. VEVRAA Federal Contractor.
$116k-170k yearly est. Auto-Apply 30d ago
Director IT Operations
Vori Health
Remote job
Who We Are:
Vori Health is an award-winning, nationwide, virtual-first, musculoskeletal medical practice focused on evidence-based care that treats the whole person. Using a unique care model to help patients find the best path forward, Vori Health connects patients to a trained care team that includes a nonoperative physical medicine physician, a health coach navigator, and a physical therapist who manage the initial patient assessment and then work to coordinate all aspects of care. We are on a mission to empower humanity to lead a healthier life.
What You'll Do:
Vori Health is seeking a highly skilled Director of IT Operations to lead and scale our technology operations in support of our mission to provide integrated, whole-person musculoskeletal (MSK) care. This role oversees the performance, reliability, and security of our cloud environments, end-user computing, IT service desk, and device lifecycle management. The Director will also play a key role in supporting the CISO with security certifications (including HIPAA and HITRUST), ongoing security initiatives, and internal and external compliance audits.
This is a hands-on leadership role ideal for an operationally-driven, detail-oriented IT leader who thrives in a fast-paced, digital-first healthcare environment.
Essential Functions:
IT Operations Leadership
Lead day-to-day IT operations across cloud infrastructure, IT service desk, and end-user technology.
Establish operational processes, service-level expectations, and performance metrics to ensure reliable, responsive support.
Develop and maintain documentation, runbooks, and IT policies to support operational consistency and scalability.
Oversee IT asset management, including procurement, inventory tracking, and lifecycle planning.
Cloud Infrastructure & Systems Management
Manage Vori Health's cloud-based environments ( AWS, Azure) in partnership with engineering and security teams.
Ensure cloud performance, reliability, availability, and cost optimization.
Oversee configuration management, access controls, and cloud resource provisioning.
Support disaster recovery/business continuity planning and periodic testing.
IT Service Desk & End-User Support
Lead the IT service desk team to deliver world-class support for internal employees and clinicians.
Oversee laptop provisioning, onboarding/offboarding workflows, device deployment, hardware troubleshooting, and end-user training.
Continuously improve help desk processes, request routing, ticket volume analysis, and automation opportunities.
Ensure timely resolution of incidents and root-cause analysis for recurring issues.
Security & Compliance Support
Work closely with the CISO to support Vori Health's security certification and compliance initiatives, including HIPAA and HITRUST readiness and maintenance.
Participate in risk assessments, vulnerability remediation, policy updates, and security awareness efforts.
Collect and prepare evidence for internal and external audits, including SOC 2 (if applicable), HIPAA audits, and HITRUST assessments.
Ensure IT operational controls are implemented, monitored, and documented.
Vendor & Technology Management
Manage IT vendors, SaaS platforms, MSP partners, and hardware providers to ensure strong service delivery and contract performance.
Evaluate new tools and technologies that enhance IT operations, security, and employee productivity.
Oversee licensing management, renewals, and cost optimization across IT services.
Leadership & Collaboration
Build, mentor, and lead a high-performing IT operations team.
Collaborate cross-functionally with Engineering, Product, Clinical Operations, People Ops, and Security teams.
Communicate operational status, risks, and initiatives to leadership in a clear and actionable manner.
Champion a culture of reliability, security, continuous improvement, and exceptional internal customer service.
Supervisory Responsibilities
Leading team of support Specialist and cloud engineers, Dev Ops engineers
Perform other projects and duties as assigned
Who You Are:
Required:
Bachelor's degree in Information Technology, Computer Science, or related field-or equivalent experience.
10+ years of progressive IT operations experience, including managing cloud environments and IT support functions along with 5 years of leadership experience.
Strong experience with IT service desk leadership, device provisioning (Mac/Windows), and SaaS administration.
Experience supporting healthcare privacy and security frameworks (HIPAA ; HITRUST strongly preferred).
Proven experience gathering and preparing documentation for security and compliance audits.
Strong knowledge of identity & access management, endpoint management (e.g., Jamf, Intune), and security best practices.
Excellent communication, stakeholder engagement, and project leadership skills.
Nice-to-Haves:
Experience in a digital health or telehealth environment.
Familiarity with HITRUST CSF certification processes.
Certifications such as ITIL, CISSP, CISM, CompTIA Security+, or HCISPP.
Experience with scripting/automation for IT operations (e.g., PowerShell, Bash, Python).
Work authorization/security clearance requirements:
Authorized or able to provide required documents to work in United States or Canada.â¯
Physical Requirements/Work Environment:
Remote work environment.â¯
While performing the duties of this job, the employee may be regularly to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.â¯
Specific vision abilities required by this job include close vision requirements due to computer work.â¯
Company Benefits
At Vori Health, we believe in fostering a supportive and rewarding work environment for our team members. We offer a comprehensive benefits package designed to support your overall well-being, growth, and work-life balance:
Competitive Salary: We offer competitive pay based on experience, skillset and the value you bring to the team.
Equity Options: As part of our commitment to long-term success, we offer equity options, giving you the opportunity to share in the growth of the company.
Health & Wellness: Our health benefits include medical, dental, and vision coverage to keep you and your family healthy. We also offer wellness programs and mental health resources to help you thrive both personally and professionally.
Retirement Plans: We provide a 401(k) plan and Roth options to help you plan for the future and enjoy peace of mind.
Paid Time Off (PTO): Enjoy generous paid time off, including vacation days, holidays, and sick leave, to recharge and maintain a healthy work-life balance.
Fully Remote Work: Work from your home or private office location! We offer a flexible, fully remote work environment that allows you to manage your workspace in a way that best suits your lifestyle.
Professional Development: We encourage continuous learning and growth with access to training resources and Professional Development stipend for further education.
Parental Leave: We offer paid parental leave to support team members through important life moments, whether you're welcoming a child or expanding your family.
Employee Assistance Program (EAP): Access confidential counseling and support for personal or work-related challenges to maintain your well-being along with additional employee assistance programs.
We're committed to creating a workplace where you can grow, succeed, and achieve your best. Come join our team and enjoy the benefits of a company that values its team members we call Vorriors!
EEO Statement:
Vori Health is an Equal Opportunity Employer. We are committed to a work environment that supports, inspires and respects all individuals without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship or other protected characteristics.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the team member for this job. Duties, responsibilities and activities may change at any time with or without notice.
$96k-143k yearly est. 39d ago
Director of Technology Operations
Community Building Strategies 3.8
Remote job
Job Description
Director of Technology Operations
About The Organization
Community Building Strategies (CBS) is a consulting firm based in Ohio that provides strategic and operational support to Non Profit organizations, donors, and businesses who are working to advance social, economic, and racial justice causes.
About The Role
We're seeking a strategic technology leader who will serve as the sole technology expert managing critical infrastructure, security, and operations across our network of progressive organizations. This hands-on leadership position requires someone who can autonomously navigate complex multi-platform environments while building strategic roadmaps, with the unique opportunity to shape technology operations that directly support grassroots organizing, voter mobilization, and social justice initiatives across multiple states.
What You'll Do
Manage and secure 95+ domains across multiple organizations, including DNS configuration, SSL certificate provisioning, nameserver management, and email setup/maintenance, while implementing proactive monitoring systems to prevent service disruptions
Conduct comprehensive audits within first 90 days covering existing operational processes, digital/physical security vulnerabilities, and technology workflows, then develop prioritized remediation roadmaps with immediate actionable steps
Develop and execute security protocols including incident response plans, access control policies, and quarterly access audits across Google Workspace, Box, and other cloud storage platforms, ensuring proper data governance and C3/C4 compliance
Oversee physical asset management for hundreds of devices including laptops, tablets, and phones, implementing tracking systems, security protocols, and working with local IT contractors for device preparation and deployment
Provide hands-on technical support including assisting website administrators with content updates, troubleshooting WordPress/Squarespace/Wix issues, and responding promptly to service outages while effectively triaging requests
Evaluate and consolidate technology infrastructure across platforms, identifying opportunities for cost optimization and process improvement while maintaining operational continuity
Partner with contractors and vendors to execute strategic initiatives, maintaining existing relationships while evaluating build versus buy decisions and determining when to bring capabilities in-house
Research and implement field operation technologies, selecting appropriate applications for canvassing teams, voter registration programs, and ensuring proper communication channels for field staff
Present recommendations to non-technical stakeholders through formal presentations, translating complex technical concepts into actionable business decisions for executive approval
Establish proactive monitoring and maintenance schedules for critical services, creating documentation, conducting training sessions, and building accountability measures across organizations
Skills We're Seeking
Domain and infrastructure management expertise including DNS, SSL certificates, email configuration, and experience managing multi-platform environments (WordPress, Squarespace, Wix, etc.)
Security operations experience with proven ability to conduct audits, create incident response plans, implement access controls, and manage sensitive data across multiple organizations
Physical device management capabilities including asset tracking, deployment strategies, and experience managing mixed environments (Apple/PC/Android) at scale
Google Workspace and cloud administration proficiency with experience in user provisioning, access management, storage optimization, and implementing governance policies across shared drives
Strong vendor and contractor management skills with ability to maintain relationships, evaluate service providers, and make strategic decisions about outsourcing versus in-house capabilities
Excellent communication and presentation abilities to translate technical concepts for non-technical stakeholders, provide clear recommendations to leadership, and collaborate across hierarchical structures
Highly autonomous work style with demonstrated ability to prioritize across multiple departments and stakeholders, manage competing urgencies, and maintain professional boundaries in fast-paced environments
Technical proficiency in web technologies including basic HTML/CSS knowledge, familiarity with content management systems, and general IT troubleshooting skills
Change management and process improvement experience with ability to assess existing systems, recommend consolidated solutions, and guide organizations through technology transitions without disruption
Mission alignment and professional maturity demonstrating commitment to progressive causes while maintaining practitioner focus, understanding nonprofit compliance requirements, and respecting C3/C4 firewall regulations
Additional Requirements
Location flexibility: Physical proximity to Northeast Ohio or surrounding area preferred, with ability to work remotely while maintaining availability during standard business hours and occasional in-person presence for critical infrastructure needs
Availability: Must maintain standard business hours availability with understanding that this is not a traditional 9-5 role during peak operational periods
Travel: Approximately 15% domestic travel for strategic meetings, professional development, and quarterly office visits if remote
Salary/Benefits
$125,000-$150,000 depending on skills and experience.
Health Insurance, Vacation Time, Sick Days, Paid Holidays, 401k, Ability to work remotely as needed, Monthly Cell Phone and Internet stipend.
$125k-150k yearly 8d ago
Director, PBM Technical Operations
Navitus 4.7
Remote job
Company Navitus About Us Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at ************************************ to be considered for internal opportunities. Pay Range USD $120,525.00 - USD $150,656.00 /Yr. STAR Bonus % (At Risk Maximum) 15.00 - Director, GM of GP, PIC Work Schedule Description (e.g. M-F 8am to 5pm) M-F 8am to 5pm Remote Work Notification ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. Overview
Do you have experience at a PBM? Navitus Health Solutions is seeking a Director, Technical Operations with no less than 5 years of experience at a PBM, health plan, or managed care environment to join our team! This is not a call center or general operations leadership roles.
The Director, Technical Operations (DTO) is responsible for providing regulatory interpretation,operational expertise and oversight of technical programs for Government Programs which include enrollment/eligibility, regulatory encounter submission and reconciliation, claims adjudication accuracy, EOB Administration, recoveries processes, EGWP enrollment, coordination of benefits, reprocessing/refund/recoveries solution deliverables, M3P, vendor contract management and RDS Administration. The Director will recommend, develop, implement, monitor and evaluate department goals, objectives, processes, and policies and procedures within the scope of the department's responsibilities. The DTO is responsible for the development, implementation and ongoing oversight of the technical operations and activities needed to support Government Programs. This individual will ensure that policies, procedures, and CMS and state program requirements are implemented to achieve effective, efficient, auditable and compliant Medicare, Medicaid and Exchange Claims Adjudication.
Is this you? Find out more below!
Responsibilities
How do I make an impact on my team?
Supports annual department budget and staffing plans in support of Navitus's strategic and business initiatives.
Monitors program regulations, guidance, and systems to determine needs and gaps that impact compliance and program operations. Provides direction and oversight for the development, modification and improvement of business processes and policies.
Oversees the accurate and timely administration, coordination, reconciliation and reporting of eligibility changes including CMS enrollment submissions for EGWP offering; retroactive Medicare D low-income subsidy eligibility changes; retroactive eligibility changes and impact assessments for Medicaid and Exchange, and changes in the primary and supplemental other insurance file and COB changes.
Oversees the processing of all CMS and state encounter data submissions and reconciliations. Ensures PDE, ED, and Exchange encounter submissions and manual and electronic claims adjustments to correct PDE/ED errors and recoveries are handled appropriately and timely. Oversees outcomes adherence to contractual and performance guarantee requirements and creates the vision for and oversees all related projects and process improvements.
Oversees and ensure compliance with the Medicare, Medicaid and Exchange claims adjudication and COB regulatory requirements.
Oversees and ensure compliance with the Medicare EOB regulatory requirements and administration as well as Medicare M3P administration and vendor management.
Oversees and ensure compliance with reprocessing regulatory requirements and timelines.
Ensures successful internal and external audits by working with claims adjudication and recoveries teams to maintain compliance with regulatory requirements and requirements for operational and financial controls.
Implements new Medicare D, Medicaid and Exchange requirements impacting claims adjudications, RDS, EGWP enrollment, EOB administration, encounter data administration, Medicare Plan Finder, and retro-eligibility requirements.
Other duties as assigned
Qualifications
What our team expects from you?
Bachelor's Degree required.
5 years' experience in PBM, health plan, or managed care environment.
Knowledge and experience in project management, claims adjudication, analytical tools and analysis, and technology solutions.
Requires proven track record of process improvement, regulatory compliance, monitoring and metrics, and leading projects and teams.
Participate in, adhere to, and support compliance program objectives
The ability to consistently interact cooperatively and respectfully with other employees
What can you expect from Navitus?
Top of the industry benefits for Health, Dental, and Vision insurance
20 days paid time off
4 weeks paid parental leave
9 paid holidays
401K company match of up to 5% - No vesting requirement
Adoption Assistance Program
Flexible Spending Account
Educational Assistance Plan and Professional Membership assistance
Referral Bonus Program - up to $750!
#LI-Remote
Location : Address Remote Location : Country US
$120.5k yearly Auto-Apply 7d ago
AVP, Out of Network Operations (Remote)
Claritev
Remote job
At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and upward!
Job Summary
This position leads, plans, develops, and directs aspects of respective cost centers, functions, and/or processes within the Referenced Based Pricing (RBP) department. The AVP is accountable for managing revenue-generating operations within the company, partnering on the technical/product roadmap, and driving strategic initiatives that require exceptional leadership and external-facing collaboration. This role demands strong operational expertise, deep healthcare knowledge, and the ability to navigate complex regulatory environments.
* Job Roles and Responsibilities
* Direct the daily operations of assigned business units to ensure consistent delivery of quality results,operational efficiency, and attainment of expectations set forth by internal and external clients.
* Own revenue performance for assigned business lines, ensuring delivery on annual budget targets and multi‑year growth commitments.
* Develop growth strategies (organic growth, service expansion, cross‑functional initiatives) with key partners in product, service, sales, regulatory/legal and technology.
* Drive operational excellence across high-revenue business units, ensuring strategic alignment with organizational goals.
* Provide leadership through real-time management and mid- & long-range forecasting, supporting succession planning and business strategy.
* Manage execution of the RBP (DiS) Services objectives through team members in a timely, cost-effective manner.
* Develop and maintain strong relationships both internally and externally, including but not limited to open communication amongst all departments within the organization to ensure company and department goals are consistently met.
* Establish, monitor and improve KPIs for cycle time, productivity, cost‑to‑serve, utilization, customer experience, and quality.
* Oversee execution and completion of complex service and claims issues, resolving them timely, effectively and with minimal supervision.
* Translate business needs into technical and service requirements, including workflow automation, platform enhancements, new features, or integrations while assisting with digital transformation strategy.
* Champion user adoption through change management, training, and communication plans.
* Partner with product and technology teams to influence and align on the technical roadmap for enhanced product delivery and operational improvements and innovation.
* Demonstrate strong appeal and negotiation skills when managing internal or external escalations and complex service issues.
* Collaborate closely with support and service teams to ensure seamless execution of operational and client objectives in delivering high-quality, scalable and efficient solutions.
* Lead large-scale healthcare operations with strong oversight of regulatory and legal compliance.
* Serve as an external-facing leader, representing the organization in client meetings, regulatory discussions, and strategic partnerships.
* Regularly communicate with organizational leadership on performance, risks, opportunities, and program updates.
* Maintain awareness of regulatory changes and proactively update operations and roadmaps as needed.
* Direct the budget process and financial planning for assigned cost center(s), balancing cost containment with department needs and customer satisfaction.
* Serve as a business sponsor for Agile application development projects and other associated client implementation initiatives.
* Select, develop, and evaluate staff to ensure efficient operation of the department, fostering engagement and performance across teams of 50-100+.
* Ensure compliance with HIPAA regulations and requirements.
* Demonstrate Company's Core Competencies and values.
* Other duties as assigned.
Job Requirements (Education, Experience, and Training)
* Minimum bachelor's degree in a relevant field coupled with 10 years' experience in an operational management/leadership role, at least 7 years of which should include healthcare markets (insurance companies, TPA, HMO, or managed care).
* Proven track record of managing high revenue streams within an organization.
* Strong leadership experience in building and scaling teams of 50-100+ members.
* Extensive experience handling client escalations and navigating litigation issues within healthcare operations.
* Deep understanding of regulatory and legal frameworks impacting large healthcare organizations.
* Proven experience partnering on technical roadmaps and driving technology-enabled operational strategies.
* Strong appeal and negotiation skills for resolving escalations and influencing outcomes.
* Demonstrated ability to collaborate effectively with internal support teams and external stakeholders.
* External-facing experience with clients, regulators, and legal entities in large-scale healthcare operations.
* Knowledge of health care and managed care products.
* Excellent communication, leadership, planning, analytical, and organizational skills.
* Ability to travel as needed.
Salary & Benefits
Salary range: $160-175K, plus health insurance, 401(k), bonus opportunity, and comprehensive benefits package.
COMPENSATION
The salary range for this position is $160-175,000. Specific offers consider a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k, and bonus opportunity.
REQUIREMENTS
[Copy this directly from JD, including any edits from the hiring manager]
BENEFITS
We realize that our employees are instrumental in our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
* Medical, dental and vision coverage with low deductible & copay
* Life insurance
* Short and long-term disability
* Paid Parental Leave
* 401(k) + match
* Employee Stock Purchase Plan
* Generous Paid Time Off - accrued based on years of service
* WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
* 10 paid company holidays
* Tuition reimbursement
* Flexible Spending Account
* Employee Assistance Program
* Sick time benefits - for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits.
EEO STATEMENT
Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.
APPLICATION DEADLINE
We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.
#LI - HR1
$160k-175k yearly 8d ago
Strategy & Operations, Infrastructure
Stripe 4.5
Remote job
Stripe is a financial infrastructure platform for businesses. Millions of companies - from the world's largest enterprises to the most ambitious startups - use Stripe to accept payments, grow their revenue, and accelerate new business opportunities. Our mission is to increase the GDP of the internet, and we have a staggering amount of work ahead. That means you have an unprecedented opportunity to put the global economy within everyone's reach while doing the most important work of your career.
About the team
The Strategy & Operations (S&O) team for Infra is responsible for enabling the continued rapid growth and operational excellence of one of Stripe's most strategic areas - the infrastructure group. This role sits at the intersection of product, engineering, strategy, finance, data, GTM and day-to-day execution, ensuring the infra organization is well-informed, running efficiently and poised to deliver on the future product needs.
As a key member of this team, you will tackle a diverse array of challenges that underpin Stripe's technical foundations which will span system scalability, platform reliability, and efficiency. You will provide the analytical rigor and operational pragmatism necessary to scale Stripe's infrastructure in a way that is both technically resilient and fiscally sustainable. Operating with a high degree of autonomy, you will lead critical strategic projects, translate complex system performance and capacity trends into actionable infrastructure requirements, and drive the high-stakes architectural and resource decisions necessary for Stripe's long-term growth.
The Infrastructure Strategy & Operations team is a vital partner to Stripe's engineering leadership and the Office of the CPTO, focused on three core pillars:
Setting and Driving the Engineering Agenda: We design the organizational structures and operating models that enable our infrastructure to scale ahead of the business. We lead critical technical governance forums and synthesize system-level health metrics such as utilization, latency, and fleet reliability into strategic insights for senior leadership.
Strategic Capacity & Infrastructure Planning: We deliver objective, data-driven strategies for our platform roadmap. By modeling future infrastructure needs against business growth forecasts, we ensure our global hardware and software investments are proactive rather than reactive, bridging the gap between deep engineering requirements and financial reality.
Program/Process Incubation: We add structure and clarity to ambiguous problems, leading and influencing large cross-functional teams to stand up and define new programs and processes that simplify how we run the business. We lead cross-functional initiatives to stand up new programs focused on infrastructure efficiency and resource optimization without compromising developer velocity.
What you'll do
Partner with Infrastructure leadership to define the long-term strategic vision and build the annual operating plans, ensuring alignment with Stripe's overall company strategy.
Maintain a pulse on the financial health/cost of Infrastructure including relevant trends, and proactively surface areas of concern or opportunity.
Build and own models for in-depth analyses & benchmark key metrics to help inform our overall strategy and make the right growth decisions for Infrastructure.
Obsess over our top infrastructure efficiency metrics, helping to surface, track, and drive initiatives that will move the needle.
Support cross-functional execution across priority projects, ensuring alignment between teams (e.g., product, engineering, marketing, sales, support).
Design and implement operational systems and processes (e.g., reporting dashboards, planning forums, decision-making workflows) that help the infrastructure group scale efficiently.
Who you are
We're looking for someone who meets the minimum requirements to be considered for the role. If you meet these requirements, you are encouraged to apply. The preferred qualifications are a bonus, not a requirement.
Minimum requirements
12+ years of experience in strategy & operations, data science, finance, product management, or similar roles at technology companies
Experience working in highly cross functional settings, and in a role that spans strategy, analysis, and operations in a fast-paced environment
Critical and first principles thinking (e.g., ability to question
how
we are working rather than simply executing), and the ability to zoom out to the most important questions
Passion for digging deep into data and problem solving
Experience in data analytics with demonstrated ability in navigating large data sets and/or SQL
Excellent written and verbal communication with the the ability to speak to leaders across different teams, such as partnerships, product, engineering, and sales
Demonstrated ability to thrive in influence without authority environments
Good balance of business and technical acumen
An ability to execute with minimal guidance, and in contexts with a high degree of ambiguity
Preferred qualifications
Previous experience in Infrastructure strategy (e.g., Compute, Storage,Networking, IT, Security or Developer Platforms), the Payments ecosystem, or high-scale Fintech is highly preferred.
Proven ability to facilitate large-scale technical forums and planning sessions, maintaining a focus on measurable goals, infrastructure SLAs, and ROI-driven outcomes.
Experience driving creative solutions for capacity and efficiency bottlenecks, with a track record of effectively influencing the roadmaps of cross-functional engineering and product teams.
$144k-212k yearly est. Auto-Apply 1d ago
Director of Backbone Network Engineering Architecture
Knology of Charleston 4.4
Remote job
WOW! is currently hiring a Director,Network Engineering to work remotely!
For remote positions, employees can sit in one of the following states: AL, AZ, CO, FL, GA, IL, IN, MI,OH, SC, TN and TX. Please only apply if you can live and work full-time in one of the states listed above; your application will not be considered or reviewed if you live outside of these states. State locations and specifics are subject to change as our hiring requirements shift.
The Director of Network Engineering will lead the Core/Backbone Network Design, Integration, and Implementation teams. This position is responsible for ensuring the team is focused on the right priorities and is delivering quality services which meet the requirements of the business.
Let us tell you about the perks!
Be part of a company whose core values include respect, integrity, spirit of service, and accountability!
Salary: Competitive Compensation (Salary may be negotiable based on experience)
Medical, dental, and vision insurance, and 401k with a company match
Paid time off, paid holidays, and tuition reimbursement.
Significant discounts on broadband packages for employees residing in our service areas.
What you'll be doing:
Essential duties and responsibilities include but are not limited to those listed below:
Lead the Design, Integration, and Implementation engineering teams in building backbone, internet-edge and data center solutions to support the services provided by WOW!.
Provide vision and strategy for service and/or network enhancement.
Monitor company KPI reports ensuring Engineers meet their individual and team goals on a consistent basis.
Drive continuous improvement initiatives resulting in increased productivity, as well as scalable and efficient processes to support the operational components of the network.
Develop short- and long-term strategic departmental plans that support the overall corporate and technology strategy.
Interface with company executives to assure investments in networks are appropriate and compatible with the industry that can scale and adapt as the business needs dictate.
Responsible for development and engagement of employees within the Design, Integration, and Implementation engineering teams.
Represent the team and their responsibilities to the rest of the business units while managing the resource funnel.
Leverage strong problem-solving skills with a primary focus on ensuring the right architectures and designs are deployed within the WOW infrastructure to support our customers.
Ensure that any lessons learned from these systemic issues are addressed through improved testing, re-designs, education and training.
Drive various aspects of the business planning activities which include preparation of capital and operating budgets, vendor management/liaison and representation at high level project and resource planning meetings.
Other duties as assigned.
What YOU need is:
To perform this job successfully, an individual must be able to perform each duty and responsibilities satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience:
B.S. (or equivalent) in Computer Science or Electrical Engineering.
10+ years of network engineering and/or operations experience.
5-7 years applying architecture and design concepts.
Prior work experience leading architecture and design teams is required.
Thorough understanding of L2/L3 network components; including Routers, Switches, and Firewalls.
Strong familiarity with MPLS, RSVP-TE, LDP, L3VPN, MVPN, Segment Routing, SRv6, BGP, OSPF, IS-IS, NETCONF, YANG, Python, Ansible and other networking/programming concepts.
Extensive experience with network hardware/software vendors: Juniper, Cisco, Arista, Nokia.
Familiar with Optical/Transport network components and concepts leveraged to build large scale networks.
Prior experience working within an Agile-based project management framework is required.
Prior experience / certifications in various networking technologies which provide demonstrated in-depth technical knowledge in routing, switching and security.
Strong communications skills with the demonstrated ability to interface with senior executives within and outside of the company.
Experience in the creation and maintenance of both departmental budgets as well as project oriented capital and operating budgets.
Strong problem management skills reflecting the ability to quickly understand the issue and apply the right resources to the problem while ensuring focus on timely resolution.
Demonstration of discipline in creating documentation and operational procedures for scalable services which can be effectively transitioned to an operations team.
Must have excellent management, organizational and interpersonal skills balanced with very strong technical skills.
Physical Demands/Working Conditions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Regularly required to talk and hear
Required to use hands to type, handle objects and paperwork
Required to use close vision and be able to focus
Must be able to travel for business purposes on an occasional basis.
Must be flexible to adjust schedule to cover various shifts.
Wondering if you should apply?
Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At WOW! we are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but don't check every box in the qualifications section, we encourage you to apply anyway. You may be just the right candidate for this or other roles.
#LI-Remote
All qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran
$103k-140k yearly est. Auto-Apply 26d ago
Director, GTM Technology Operations and PMO
Procore Technologies, Inc. 4.5
Remote job
We are seeking an exceptional Director, GTM Technology Operations and PMO, to drive operational excellence and strategic initiaves, in GTM Systems, Data and Process organization. This leadership position will be instrumental in shaping how we scale our operations, optimize processes, and deliver world-class services that power Procore's growth.
In this role, you will be driving the operational arm of the GTM Technology function through rigorous oversight, leading the cross-functional program management of our most critical GTM initiatives. You will act as the bridge between technical execution and business outcomes, ensuring we aren't just delivering features, but delivering business value.
This opportunity can work remotely from any US location, and we are looking for someone to join us immediately.
What You'll Do:
Strategic Partnership & Execution
* Act as a Strategic Partner & Cross-Functional Orchestration: Collaborate with IT delivery leads across Sales, Alliances, Marketing, Finance, and Product. You will align GTM technology priorities to business goals, ensuring cross-functional execution is consistent, on track, and transparent.
* Launch High-Impact Initiatives: Launch and scale strategic programs that accelerate revenue growth and strengthen GTM application delivery capabilities. You will partner with delivery leads to ensure rigorous prioritization and high-performance execution.
* Executive Counsel: Provide executive-level counsel and support through briefing materials, agenda setting, strategic communications, and program orchestration. You will serve as the primary liaison to executive stakeholders, translating technical progress into business impact.
Operational Excellence & Financial Governance
* Own the "Business of IT": Own departmental budgets, OKRs, and utilization metrics. You will drive financial discipline, proactive performance management, and alignment to company objectives, ensuring we are tracking towards the business outcomes our technology initiatives are driving.
* Budget Management: Own the GTM Technology departmental budget. Oversee forecasting, variance analysis, and software licensing optimization to ensure fiscal responsibility.
* Establish Operating Rhythms: Design and maintain operating rhythms (status reports, QBRs, planning sessions) that drive accountability, transparency, and executive alignment across the organization.
* Architect Scalable Frameworks: Architect scalable operational frameworks and lead continuous improvement initiatives to enhance efficiency, enable KPI-driven decision-making, and optimize resource allocation.
Program Delivery & Transformation
* Outcome-Based Metrics & Executive Reporting: Define and implement metrics that measure business outcomes (e.g., revenue velocity, efficiency gains) over mere technical outputs. Create dashboards and deliver regular executive reporting to communicate portfolio health, value realization, and ROI to C-suite and VP-level leaders.
* Cross-Functional Delivery Oversight: Review delivery across Lead-to-Cash systems (CRM, CPQ, Billing, Analytics, and downstream integrations) to ensure seamless operations, trusted data, and transparency across GTM teams.
* Consulting Mindset & Transformation Agent: Identify and resolve GTM process inefficiencies using a consulting mindset to deliver scalable, data-driven solutions with speed and precision. You will act as a transformational agent, bringing an enterprise mindset to scale our processes as Procore grows.
* Change Management: Lead the organizational and cross-functional change management strategy for complex rollouts, ensuring that engineering outputs result in high user adoption and minimal disruption.
* Team Leadership: Recruit, mentor, and lead a high-performing team of Program Managers, Scrum Masters, and IT Operations Analysts, fostering a culture focused on business outcomes through technology.
What You'll Need:
Experience & Education
* Bachelor's degree in Business Administration,Operations Management, Computer Science, or a related field (MBA preferred).
* 15+ years of progressive leadership experience in technology operations, program management, and/or business transformation at enterprise companies.
Leadership & Skills
* GTM Fluency: Strong understanding of the Lead-to-Cash lifecycle and the engineering complexity behind GTM systems (Salesforce, Marketo, Zuora, etc.).
* OKR Mastery: Strong background in OKR methodology and implementation; ability to connect daily tasks to high-level strategic goals.
* Metrics & Measurement: Excellence in performance measurement and metrics tracking. You have key experience and leadership tracking metrics to ensure we are tracking towards the business outcomes our technology initiatives are driving.
* Program Delivery & Communication: Proven experience leading IT PMO teams, in stakeholder management and executive communication.
* Financial Acumen: Deep experience managing large budgets , resource capacity planning, and vendor/contract management in a large-scale IT organization.
Additional Information
Base Pay Range:
174,400.00 - 239,800.00 USD Annual
For Los Angeles County (unincorporated) Candidates:
Procore will consider for employment all qualified applicants, including those with arrest or conviction records, in accordance with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the Los Angeles County Fair Chance Ordinance for Employers, and the California Fair Chance Act.
A criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment: 1. appropriately managing, accessing, and handling confidential information including proprietary and trade secret information, as well as accessing Procore's information technology systems and platforms; 2. interacting with and occasionally having unsupervised contact with internal/external customers, stakeholders, and/or colleagues; and 3. exercising sound judgment.
$129k-164k yearly est. 8d ago
Remote (EST or CST) - Global Network Manager
Insight Global
Remote job
Insight Global is looking for a Global Network Manager to support their 24x7 operations of their European Data Center including the design, implementation of organizations global foundational IT Infrastructures (data centers, hybrid, and cloud workloads) and related core IT assets. This position ensures that the infrastructure is robust, scalable and aligned with the business objectives while optimizing cost, performance, reliability and security for group services as well as locally deployed solutions
Job Responsibilities
- Deliver and maintain hybrid cloud infrastructure services and patterns provided by group as a global service
- Facilitate continual adoption/migration to group infrastructure services
- Interface with technical and application teams/providers/partners (internal and external) across the globe to ensure that we deliver reliable and efficient IT operations
- Participate in the operational support of the infrastructure; including crisis, incident management and problem management
- Ensure global/local governance, reporting and compliance is in place for responsible services. This includes establishing and monitoring key performance indicators (KPIs) to assess the effectiveness of infrastructure operations and drive improvement
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: ****************************************************
Skills and Requirements
- 10+ years of experience working in an IT environment
- 8-10 years of experience with Cisco Meraki
- 8-10 years of hands on Firewall experience (Fortinet is preferred)
- Cloud Networking experience (Azure is preferred) in a Data Center
- In-depth knowledge of infrastructure technologies including networking, virtualization,operation systems knowledge of Linux, Windows & AS400 operating systems
- 3 years of experience managing a distributed global network of an enterprise company
- Bachelors degree in Information Technology, Computer Science, Engineering or related field -Agile expereince
$73k-109k yearly est. 7d ago
Network Partnerships Manager (Remote - Digital Healthcare)
Rippl Care
Remote job
Job Description
If you got into healthcare to make a difference, you're in the right place. We're looking for a values-driven, mission-focused, dynamic Network Partnerships Manager who is passionate about working with seniors (and their families), especially those navigating challenges with dementia. Someone who is searching for a workplace and culture that is as committed to them as they are their patients. If that's you, read on!
What's Rippl?
At Rippl, we are a passionate, impatient, slightly irreverent, people-obsessed group of optimists & doers intent on building a movement to bring dementia care to our aging population. We believe there is no more noble mission than caring for people at this critical stage of life, and we're ready to take action.
We're reimagining what dementia care for seniors can be. By leveraging an obsession with supporting our clinicians, a new care model and disruptive technology, we are pioneering an entirely new way to democratize senior access to high quality, wrap-around dementia care, for seniors and their families and caregivers. Helping them stay healthier, at home longer, and out of the ER and hospital.
Our Mission
The Rippl Mission is to enable more good days for those living with dementia and their families.
Our Core Values
At Rippl, we live and breathe a set of shared, core values that help us build the best team to serve our patients, families and caregivers.
We're fed up. Today's dementia care isn't working. Too many families are struggling to find the support they need, and too many seniors are left without the care they deserve. We know it can be done better-so we're doing it.
We're changemakers. We're pioneering a new, better care model that actually works for people living with dementia and their families. We use evidence-based care, technology, and human connection to deliver the support that people need-when and where they need it. And we're proving it works.
We're in a hurry. The need for high-quality dementia care has never been greater. The number of people living with dementia is growing at an unprecedented rate. Families need help now, and we refuse to wait.
We start with yes. We don't let barriers stop us. When faced with a challenge, we figure it out-together. We're problem-solvers, innovators, and doers who find a way to make things happen for the people who need us.
We care for those who care for others. Great care starts with the people delivering it. We are obsessed with supporting our care team-because when they feel valued and empowered, patients and caregivers get the care they deserve.
Join the movement
We're looking to find other changemakers who are ready to join our movement.
The Role:
The Network Partnerships Manager will be responsible for developing, managing, and maintaining strategic partnerships that fill service area gaps for our GUIDE program. This role builds collaboration between external partners and internal teams, ensuring all partnerships are set up for success, efficiently managed, effectively deliver services, and are compliant.
This role will both build relationships with home care partners and administer the program to ensure high-quality services are delivered for all eligible patients. Building relationships focuses on identifying partners with coverage in the service areas important to Rippl, negotiating relationships and contracting, and facilitating smooth partner onboarding and support processes. The Network Partnerships Manager will also maintain critical datasets and tools, such as CMS portals, accounting systems and clinical systems.
Responsibilities
Partnership Development & Management
Work with existing partners to onboard new offices as needed and ensure they are set up in CMS (Medicare)
Develop and establish new partnerships to fulfill home care service needs in key locations
Negotiate relationships with potential partners, track the progress of multiple partnership opportunities, manage contracting, and onboard partners to CMS
Manage existing partnerships to address gaps in care, invoice issues, and other partner inquiries, and ensure smooth communication and collaboration between our organizations
Prepare and deliver training materials, webinars, and resources to support partner success
Track service delivery and perform QA to ensure partner Service Level Agreements are met and contract terms are maintained
Maintain partner contact information and service area coverage in systems and databases including Salesforce, and CMS portals
Cross-functional Collaboration
Collaborate with Growth and Partner Success to understand service area needs and identify new partner opportunities.
Work closely with the Guide Program Manager to submit partner rosters and ensure proper documentation of service areas
Coordinate with Clinical and Patient Engagement teams to support patient care issues, document standard operating procedures and job aids for internal teams, and support training as needed
Identify and pursue opportunities to improve processes and patient, partner and care team experience
CMS Partner Requirements Management
Collaborate with the GUIDE Program Manager to submit and maintain accurate partner rosters and zip code lists for CMS
Oversee partner invoicing, ensuring reconciliation and timely approvals
Other Duties as Assigned
Support GUIDE functions as necessary to ensure smooth operations and responsiveness to CMS requirements
Develop reporting and analysis to support team functions
Qualifications
Bachelor's degree in healthcare administration, business, or a related field
3+ years of experience in partner management, program management, business development, provider relations or healthcare operations
Strong ability to build relationships and manage external partnerships
Excellent organizational and project management skills, with experience in managing data tools and reporting
Home care agency experience, familiarity with healthcare partnerships and CMS or Medicare programs is a plus
Strong communication skills, both written and verbal, to facilitate partner meetings, training, and ongoing collaboration
Strong organizational skills and attention to detail, with the ability to manage multiple projects simultaneously
Ability to work flexibly and collaboratively in a fast-paced environment
What's in it for you
Development, mentoring and training designed to help you chart your dream career and make sure you are learning everything you need to know as you gain more responsibility
Fast growth company with opportunities to take on more responsibility or develop into new roles
Flexible work environment and the opportunity to work from home
Competitive compensation
401(k) plan with a company contribution
Medical, Dental and Vision coverage for you and your family
Life insurance and Disability
Remote Work stipend
Generous Paid Time Off
Pay Range Details
The pay range(s) below are provided in compliance with state specific laws. Pay ranges may be different in other locations. Exact compensation may vary based on skills, experience, and location.
Role: Range is $75,000 - $98,000 depending on experience
We are going to make some very big waves starting with a small Rippl - come join us!
$75k-98k yearly 12d ago
Medicare Network Manager
MTM 4.6
Remote job
What Will Your Job Look Like?
The Medicare Network Manager will primarily be responsible for the development and maintenance of specialized networks to meet the needs of Medicare Advantage populations. The Medicare Network Manager will own the delivery of a high level of service to our vendors every day, ensuring high operational standards and vendor satisfaction within an assigned geographic area. The Medicare Network Manager would manage the day-to-day interaction with the vendors, acting as an Account Manager to build and sustain strong working relationships with cross functional departments and assigned Providers. This role is key to the success of a successful relationship with our Transportation Providers.
Location: Work From Home
What You'll Do:
Work with the Transportation Provider (TP) to follow through on service issues, troubleshooting problems and concerns, complaints, and education
Utilize data to develop and deliver performance improvement plans (PIP)
Coordinate and conduct monthly provider performance evaluations
Conduct off boarding for providers not meeting standard expectations
Serve as the first point of contact for all vendor service requests and escalations
Own the day-to-day vendor interaction and satisfaction
Conduct on site vehicle inspections and provider audits to verify compliance with MTM and HIPAA guidelines
Deliver timely, accurate and professional operational support to all vendors within a specified geographic area and Service Level Agreements
Demonstrate proactive leadership by working with internal MTM teams and external client teams, when necessary, to ensure complete resolution of TP issues
Demonstrate proficiency by providing effective consultation to TP's and guidance to internal team members
Utilize Salesforce as the single source of truth for managing vendor interactions and credentialing compliance
Recognize opportunities to educate TP's contacts on MTM processes when necessary
Build and sustain a strong working partnership with assigned transportation providers
Assist with/participate/facilitate regular provider town hall meetings
Handle inbound service requests and ensure that they are properly assigned or addressed
Liaise with other internal departments as required to resolve vendor's issues and questions
Provide ongoing support to transportation providers regarding claims, payments, eligibility, utilization management or any other questions impacting provider performance
Meet or exceed assigned KPI's and business objectives
Meet all provider compliance requirements, including but not limited to inspections, audits and credentialing, ensuring non-compliant Vendors are not performing services for MTM
Submit provider configuration changes to data management team and partner with them to ensure vendor is set up properly in the systems
What You'll need:
High School diploma or GED
College Degree or Equivalent Work Experience
2-5 years' experience as an Account Manager
2 years' operational experience
Must possess a valid driver's license
Must be able to conduct inspections, audits, communicate issues, and corrective actions from an authoritative position but with professional courtesy
Skills:
Demonstrate excellent time management skills
Knowledge of transportation logistics, patient experience, and managed care
Ability to maintain positive and team focused during high stress situations
Persuasive negotiator
Strong ability to pay attention to detail
Excellent communication skills
Ability to maintain high level of confidentiality
Must be able to communicate with staff of all job levels professionally
Ability to prioritize assigned projects, incidents, and requests
Ability to identify with customers' needs and circumstances
Ability to recognize, handle and refer situations of an emergent nature
Even Better If You Have:
Experience in Project Management and/or Contract Negotiations is preferred
Experience in Cost Management is preferred
What's in it for you:
Health and Life Insurance Plans
Dental and Vision Plans
401(k) with a company match
Flexible Scheduling
Paid Time Off and Holiday Pay
Maternity/Paternity Leave
Birthday Holiday
Casual Dress Environment
Tuition Reimbursement
MTM Perks Discount Program
Leadership Mentoring Opportunities
Salary:
Min: $50,000
Max: $60,000
This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss this with us as you move through the selection process.
Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law. If you are in need of accommodations, please contact MTM's People & Culture.
#MTM
$50k-60k yearly Auto-Apply 2d ago
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