Provider Network Risk Manager

MedRisk; United States; On-site; USD 120,000 - 160,000; Full time

Job summary

MedRisk seeks a strategic Risk 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 of accountability for provider reimbursement disputes, ensuring network partners operate in alignment with contractual, regulatory, and operational expectations.

Qualifications

• 7-10 years of experience in Network Management and/or Group Health.
• Experience working in or with Bill Review disciplines.
• Strong written and verbal communications.
• Experience working in a matrixed organization and effective with multi-stakeholder management.
• Excellent relationship management and issue resolution skills.
• Enjoys managing talent at all levels; familiarity working with offshore teams a plus.
• Proven experience in vendor management.
• Excellent organizational, analytical, and communication skills.

Responsibilities

• Dispute prevention & resolution and related policy enforcement.
• Design and maintain network performance dashboards and metrics.
• Own the lifecycle of network-related solutions that enhance compliance, savings, and stakeholder satisfaction.
• Collaborate with internal teams and external partners (sales, accounts, RFPs, product launches) to implement improvements.

Skills

Network Management

Group Health

Bill Review

Stakeholder Management

Vendor Management

Communication

Leadership

Analytical Skills

Job description

MedRisk seeks a strategic Risk 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 of accountability for provider reimbursement disputes, ensuring network partners operate in alignment with contractual, regulatory, and operational expectations.