VP Network Operations

Devoted Health; New Hampshire; À distance; USD 258 000 - 293 000; Plein temps

Avantages offerts par ce poste

Health/dental/vision plan

Generous paid time off

$100 monthly mobile or internet

Stock options

Bonus eligibility

Parental leave

401K program

Full-time only disclaimer

Résumé du poste

Devoted Health is seeking a VP, Network Performance to own the operational backbone of our provider networks serving 538,000 Medicare Advantage members. This fully remote role requires residing in a contiguous 50 states and leads a multi-disciplinary team to scale data-driven provider data management and contracted performance.

You'll drive KPI improvements, automate workflows with Engineering and Product, and partner with Contracting to ensure networks support members, providers, and claims

Qualifications

• 12+ years in health plan or managed care.
• 7+ years leading provider network ops.
• Experience with provider data management and credentialing.

Responsabilités

• Set vision, roadmap, budget, and staffing for Network Operations.
• Load and configure negotiated agreements for claims payment.
• Lead provider engagement and build a provider performance scorecard.
• Partner with Engineering and Product to automate workflows and build KPIs.

Connaissances

Provider network leadership

Health plan experience

Data governance

KPI improvement

Contract configuration knowledge

Formation

Bachelor's degree or equivalent

Outils

MDM platforms

RPA / AI

FHIR provider directory

Description du poste

Job Description

This role is fully remote and must be located within one of the contiguous 50 states.

This role is fully remote and must be located within one of the contiguous 50 states.

A bit about this role

• You'll join Devoted's Network team, which builds and supports the provider networks that care for more than 538,000 Medicare Advantage members, and which is expanding to 1,341 counties across 34 states in 2027.
• As VP, Network Performance, you'll own the operational backbone of our network: provider data in order to inform performance decisions. Where our contracting teams negotiate agreements, you'll make sure they work in practice for members, providers, and claims and it will be equally important to use data to direct contracting and recontracting efforts across all markets.
• This is a builder's role. You'll scale a performance management operation that oversees thousands of providers, replacing manual work with automated, data-driven processes.
• You'll report to the [SVP / Chief Network Officer], lead a team and partner closely with Network Contracting, Engineering, Claims, Compliance, Finance, and Devoted Medical.

Required skills and experience

• 12+ years of health plan or managed care experience, including 7+ years leading provider network operations functions such as provider data management, contract configuration, credentialing, or provider service.
• 5+ years of senior leadership experience managing multi-layered teams (directors and managers) and external vendor or BPO partners.
• Deep knowledge of Medicare Advantage network requirements, including CMS network adequacy standards and HSD submissions, provider directory requirements (including Medicare Plan Finder submissions), NCQA credentialing standards, and audit readiness.
• Demonstrated experience translating complex provider contracts and payment methodologies (fee-for-service, capitation, and value-based arrangements) into accurate claims configuration.
• Proven record of improving operational KPIs through process redesign, data governance, and technology; Bachelor's degree or equivalent combination of education and experience.

Desired skills and experience

• Experience scaling network operations through multi-state expansion at a high-growth or technology-enabled health plan, including D-SNP and C-SNP products.
• Hands-on experience implementing provider data management or MDM platforms, roster automation, AI or RPA solutions, and FHIR-based provider directory standards.

Your Responsibilities and Impact will include

• Set the vision, roadmap, budget, staffing model, and vendor strategy for Network Operations, aligned with Devoted's market expansion plans and annual CMS bid cycles, and build a high-performing team.
• Ensure every negotiated agreement (fee-for-service, capitated, and value-based) is loaded and configured accurately for claims payment, reducing contract-to-configuration cycle times and payment errors in partnership with Claims and Payment Integrity.
• Lead provider engagement and build a provider performance scorecard to assist markets with providers’ financial review, unit cost analysis and overall market trends that require intervention.
• Partner with Engineering and Product to automate high-volume workflows and build the KPIs and dashboards that let Network Operations scale without proportional headcount growth.

Salary Range: $257,500-293,000 base plus bonus and equity

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium
• Generous paid time off
• $100 monthly mobile or internet stipend
• Stock options for all employees
• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
• Parental leave program
• 401K program
• And more....
• Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going - all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted's Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.