Product Director - Network

Role overview This director-level role leads the product direction of a healthcare network platform, owning how pricing, provider data, and partner integrations come together to support employer health programs. The position sits at the intersection of network strategy, engineering, and commercial teams, ensuring the organization can credibly commit to and deliver on every market it sells into.

Responsibilities - Partner with go-to-market and sales to scope network capability per market, including provider coverage, third-party administrator readiness, and integration sequencing - Write detailed integration requirements covering inbound claims, priced output, remittance, eligibility, SLAs, file cadence, and reconciliation - Own the end-to-end path from signed rate sheets to correctly priced claims, including ingestion, normalization, versioning, validation, and audit - Define the provider data model and hierarchy, and make network adequacy and directory accuracy measurable - Evaluate new group types and segments, recommending against options that do not fit the operating model - Anticipate payment-side consequences of network changes and coordinate with payments and financial services teams before launch

Requirements - Hands-on fluency with reimbursement mechanics, including billed versus allowed versus paid, fee schedules, percent-of-Medicare, per diem, case rate, DRG, and percent-of-charge - Background at a health plan, TPA, repricing or payment-integrity vendor, reference-based-pricing administrator, provider revenue-cycle organization, or network contracting group - Working knowledge of 837 and 835 file exchange and eligibility data flows - Confidence representing the company directly with brokers, TPA executives, and health systems - Self-directed approach to defining priorities without a pre-built roadmap - Sufficient technical fluency to read data models, write SQL, and direct engineers clearly

Nice to have - Experience with self-funded employer health, including direct contracting, reference-based pricing, or captives - Track record running platform migrations or vendor claims-system implementations - Founder or early-operator experience, or meaningful use of automation and AI to replace manual operations