Network Operations Liaison

Role Overview

• Evaluate network capabilities: Assess Personify Health network capabilities and define clear feasibility guidelines to support client commitments, sales opportunities, and solution design.
• Lead network integration design: Design the end-to-end plan, member, and client experience as it relates to carrier and network integration, including Domestic Tier & Hospital Design structure and configuration logic.
• Serve as RFP network expert: Act as primary point of contact for all network-related RFP inputs, feasibility assessments, and design questions during sales processes.
• Coordinate cross-functional operations: Liaison between Account Management, Implementations, Data Operations, and external carrier/network partners to troubleshoot and resolve operational issues.
• Build tracking and accountability systems: Design and maintain tracking systems (consolidated Jira dashboards or automated summaries) to monitor all outstanding requests with networks, carriers, and payors across the enterprise.
• Conduct performance reviews: Lead weekly/monthly reconciliations and performance check-ins with each network/carrier/payor, managing backlogs and monitoring SLA adherence.
• Remove operational barriers: Intervene with networks to resolve aged issues, realign expectations when workflows fall behind, and connect disparate contacts within single networks to streamline communication.
• Manage escalations and SLAs: Support Account Managers and Implementation Managers in preparing escalations to brokers, clients, or carrier leadership while defining and maintaining SLA frameworks for implementations, renewals, and issue resolution.
• Drive continuous improvement: Refine processes, relationships, and workflows to continually improve network partnership efficiency and outcomes.

Requirements

• Bachelor's degree in business administration, healthcare management, or related field
• 7+ years in network operations, vendor management, or related healthcare services role
• Experience defining, managing, and enforcing SLAs with external partners
• Proven track record managing complex cross-functional initiatives and external vendor relationships with major carriers
• Deep understanding of healthcare networks and carrier operational workflows (Anthem, Aetna, UHG, Cigna structures, file exchanges, service models, escalation paths)
• Knowledge of TPA operational processes including claims workflows, eligibility exchanges, provider/network configurations, and benefit design implications
• Proficiency with EDI file formats and standards (837, 835, 834, 270/271) and ability to interpret and troubleshoot file exchange discrepancies
• Understanding of network tiering, hospital design, and benefit configuration frameworks
• Working knowledge of Jira or similar ticketing systems for consolidating cross-team workstreams
• Knowledge of legal, contractual, and regulatory requirements related to healthcare network operations

Benefits

• Competitive base salary and benefits effective day one
• Comprehensive medical and dental through our own health solutions (yes, we use what we build)
• Unlimited PTO—rest and recharge time is non-negotiable
• Mental health support, retirement planning, and financial protection
• Professional development with clear career progression and learning budgets
• Mission-driven culture where diverse perspectives drive real impact on people's health