Partner Products & Networks Lead

• Own the strategy, contracting, implementation, and performance management of provider network and care pathway partnerships.
• Identify and evaluate new provider network opportunities.
• Develop differentiated network configurations to support broker distribution.
• Ensure network economics align with underwriting and pricing strategy.
• Support geographic expansion with scalable network infrastructure.
• Build partnerships with centers of excellence, specialty providers, and clinical programs.
• Structure bundled pricing or value-based agreements.
• Integrate care pathways into clinical and claims workflows.
• Ensure pathways are operationally executable, measurable, and scalable.
• Lead negotiations with provider groups, networks, and specialty partners.
• Establish performance-based terms, SLAs, data-sharing requirements, and governance.
• Align contracts with stop-loss, reimbursement, and regulatory requirements.
• Coordinate with Legal and Finance through contract execution.
• Partner with TPA leadership for integration into systems.
• Establish implementation timelines, go-live criteria, and escalation paths.
• Monitor performance post-launch and drive operational optimization.
• Define and track KPIs for cost, access, utilization, and member experience.
• Conduct partner performance reviews and identify improvement opportunities.
• Resolve operational friction points impacting claims accuracy and member experience.
• Refine network and pathway strategy based on performance data.

• 7–10+ years of experience in provider networks, care delivery partnerships, or TPA/health plan operations.
• Direct experience in negotiating and contracting provider or network agreements.
• Strong understanding of claims administration, stop-loss structures, and reimbursement models.
• Experience working within or alongside a TPA, carrier, MGU, or self-funded plan environment.
• Proven ability to lead cross-functional initiatives from strategy through execution.
• Experience with specialty pharmacy or high-cost episode management (nice to have).
• Exposure to value-based contracting models (nice to have).
• Experience with broker-distributed health plans (nice to have).
• Familiarity with level-funded or self-funded plan design (nice to have).

Pay range: $120K - $200K

• Competitive compensation
• 100% company-paid comprehensive health, vision & dental insurance for you and your dependents
• Supplemental Life, AD&D and Short-Term Disability coverage options
• Discretionary time off
• Opportunity for rapid career progression
• 3 months of paid parental leave and flexible return to work policy (after 12 months of employment)
• Work-from-home stipend for remote employees
• 401(k) account
• Other benefits are coming soon!