Network Quality & Risk Lead (Provider Disputes)

Medata Inc.; California; Presencial; USD 105.000 - 130.000; Jornada completa

Descripción de la vacante

Medata Inc. is seeking a strategic Network Quality Manager to oversee provider network performance with a strong emphasis on dispute avoidance, dispute resolution, and risk mitigation within the workers’ compensation bill review process.

You will serve as the central point for provider reimbursement disputes, ensuring alignment with contracts and regulatory expectations while reducing dispute volume and protecting financial and reputational risk.

Formación

• 7-10 years of experience in Network Management or related field.
• Experience with bill review disciplines and provider reimbursement disputes.
• Strong written and verbal communication skills.
• Experience in a matrixed organization with multi-stakeholder management.

Responsabilidades

• Oversee provider network performance with focus on dispute avoidance and risk mitigation.
• Act as central point for provider reimbursement disputes and ensure compliance with contracts and regulations.
• Collaborate with legal, clinical, and compliance teams to resolve disputes efficiently.

Conocimientos

Network management

Dispute avoidance

Stakeholder management

Descripción del empleo

Medata Inc. is seeking a strategic Network Quality Manager to oversee provider network performance with a strong emphasis on dispute avoidance, dispute resolution, and risk mitigation within the workers’ compensation bill review process.

You will serve as the central point for provider reimbursement disputes, ensuring alignment with contracts and regulatory expectations while reducing dispute volume and protecting financial and reputational risk.