Pegasus Knowledge Solutions, Inc. · 4 days ago
Network Product Manager
United States
Full-time
Remote
Senior Level
7+ years expPegasus Knowledge Solutions, Inc. is seeking a strategic and analytical Network Product Manager to lead and refine their provider network solutions. The role focuses on dispute avoidance, resolution, and performance monitoring within the workers’ compensation bill review process, ensuring high-performing and compliant network products.
Information Technology
Hiring Manager
Vivek Mishra
Responsibilities
Develop and enforce network policies and workflows to provider reimbursement disputes related to PPO discounts, provider contracts, and post-bill review reductions
Analyze provider appeals and adjustments to identify trends and root causes, recommending data-driven improvements
Collaborate with legal, clinical, and compliance teams to resolve provider disputes efficiently and consistently
Promote proactive communication with providers to enhance understanding of reimbursement processes and reduce conflict
Design and maintain network performance dashboards tracking metrics
Collaborate with analytics teams to evaluate network quality, effectiveness, and impact on claims outcomes
Own the lifecycle of network-related solutions that enhance compliance, savings, and stakeholder satisfaction
Translate client requirements and regulatory changes into actionable product improvements
Monitor market and regulatory trends to guide product innovation and maintain competitive advantage
Serve as the subject matter expert on network products, provider performance, and dispute processes
Partner with internal teams—including sales, account management, RFPs, and product launches
Collaborate with external vendors and partners
Qualification
Required
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
Proven experience in vendor management
Excellent organizational, analytical, and communication skills
Preferred
familiarity working with offshore teams a plus
Company
Pegasus Knowledge Solutions, Inc.
Founded in 1997, PKSI [Pegasus Knowledge Solutions, Inc.] is an independent, advanced analytics software and services organization, that partners with the industry leading providers to help customers create value from their data, bringing a range of talents, including data integration and preparation, big data environments, data mining, predictive analytics, machine learning and text mining, as well as dashboarding and visualization.
201-500 employees
H1B Sponsorship
Pegasus Knowledge Solutions, Inc. has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2023 (3)
2022 (11)
2021 (2)
2020 (13)
Funding
Current Stage
Growth StageLeadership Team
Lawrence Hall
Director of AI Solutions and Partnerships
Company data provided by crunchbase