Remote Provider Network Operations Manager - Scale & Quality

Remote Genie; Northern (KY); Hybrid; USD 100,000 - 115,000; Full time

Benefits offered by this job

Health coverage

Dental coverage

Vision coverage

HSA options

FSA

Equity grant

401(k) program

Vacation policy

Parental leave 16 weeks

Fully remote (US)

Job summary

Pomelo Care is seeking a Manager of Provider Network Operations to scale a multi-license-type provider network for its Midlife line. You will partner with Recruiting, Licensing & Credentialing, Product and Clinical Leadership to build processes, programs, and infrastructure for growth, utilization, and quality across the network.

You will own relationships, define metrics, and build dashboards to monitor network health.

Qualifications

• 3 years of work experience, with 1+ years in provider network management, provider success or network operations.
• Ownership over key network metrics including growth, retention, utilization and quality.
• Ability to build and optimize processes, new or existing.
• Strong cross-functional communicator across Clinical, Product, Compliance and Commercial teams.
• Strong analytical skills and data-driven decision making.
• Comfortable with ambiguity and fast-paced early-stage environments.
• Nice to have: experience in women’s health or multi-license-type clinician networks.

Responsibilities

• Set and report on network capacity targets; close gaps before patient access is affected.
• Work with Recruiting, Licensing & Credentialing, Learning teams to speed time from contract to first visit.
• Own end-to-end provider relationships including orientation, utilization and retention.
• Define and track provider utilization metrics; translate insights into fixes.
• Build and run programs (incentives, community) to keep clinicians practicing within Pomelo.
• Partner with Quality to define good looks and translate standards into participation criteria.
• Monitor provider-level quality data and drive action on outliers with Clinical leadership.
• Support quality-based remediation and contract termination decisions per standards.
• Serve as connective tissue across Licensing, Credentialing, Quality, Clinical Ops, Product.
• Build reporting and dashboards to view network health clearly.
• Represent provider network in planning and flag risks before they become urgent.

Skills

Provider network management

Metrics ownership

Process design

Cross-functional communication

Data analysis

Adaptability

Women’s health experience

Job description

Pomelo Care is seeking a Manager of Provider Network Operations to scale a multi-license-type provider network for its Midlife line. You will partner with Recruiting, Licensing & Credentialing, Product and Clinical Leadership to build processes, programs, and infrastructure for growth, utilization, and quality across the network.

You will own relationships, define metrics, and build dashboards to monitor network health.