Network Operations Laision

Who We Are

Because health is personal. Thats why Personify Health created the first and only personalized health platformbringing health plan administration holistic wellbeing solutions and comprehensive care navigation together in one place. We serve employers health plans and health systems with data-driven solutions that reduce costs while actually improving health outcomes. Together our team is on a mission to empower people to lead healthier lives.

Learn even more about the work that drives us at .

Ready to Orchestrate Seamless Network Partnerships That Power Client Success

Why This Role Matters

Network operations can make or break client implementations and ongoing satisfaction. As our Network Operations Liaison youll serve as the critical connection point between our TPA and Wellbeing Operations teams and major national healthcare networks. Youll ensure file exchanges flow smoothly claims acquisition processes run without hiccups and carrier relationships stay productive. Your strategic oversight and hands-on problem-solving directly impact whether clients experience seamless network integration or frustrating operational barriers.

What Youll Actually Do

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.

What You Bring to Our Team

Education & Experience:

• Bachelors 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

Technical Skills:

• 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 (/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

The Highlights:

• Competitive base salary and benefits effective day one
• Comprehensive medical and dental through our own health solutions (yes we use what we build)
• Unlimited PTOrest 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 peoples health

Want the full pictureVisit explore our complete benefits package wellness programs and other employee perks.

Compensation: This position offers a base salary range of $95000 - $110000 depending on location skills and experience. Youre eligible for our full benefits package starting day one.

Our Commitment:Personify Health is an equal opportunity employer committed to diversity equity inclusion and belonging. We cultivate a work environment where differences are celebrated and employees of all backgrounds are empowered to thrivebecause diversity is core to who we are and critical to our work in health and wellbeing.

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