MedRisk · 3 hours ago
Network Product Manager
US
Full-time
Onsite
Senior Level
7+ years expMedRisk is a leader in medical cost containment solutions, and they are seeking a Network Product Manager to define and evolve their Medical Bill Processing and PPO Networks. This strategic role involves developing product vision, evaluating network partnerships, and collaborating across teams to enhance network effectiveness and client outcomes.
Hospital & Health Care
Responsibilities
Define and execute the long-term product strategy for Medical Bill Review, repricing, and PPO network solutions
Establish MedRisk as a thought leader and innovator in medical cost containment and network optimization
Develop and articulate a clear value proposition for national, regional, and specialty network offerings
Continuously assess market trends, regulatory developments, and competitive dynamics to evolve product strategy
Own the end-to-end process for evaluating PPO networks and sub-networks, including national, regional, and specialty offerings
Develop and maintain a formal network evaluation framework that assesses: Provider access and geographic coverage, Repricing performance and savings consistency, Provider contract quality and fee schedules, Data transparency, reporting, and operational integration, Compliance, defensibility, and audit support
Identify the optimal mix of networks and sub-networks to maximize savings, access, and client outcomes
Lead network partner selection, rationalization, and ongoing performance reviews, including recommendations to add, sunset, or replace networks
Partner with Legal and Compliance to evaluate contractual terms, regulatory risk, and network defensibility
Design and oversee a tiered network strategy that balances: National PPO coverage, Regional market strength, Specialty network depth
Identify coverage or performance gaps and define strategies to strengthen network reach and effectiveness
Ensure network configurations are optimized for client needs, jurisdictional requirements, and specialty use cases
Ensure network and sub-network selections directly support medical bill review workflows, repricing accuracy, and cost containment goals
Collaborate with Operations and Clinical teams to ensure network design supports accurate repricing, defensibility, and dispute resolution
Drive improvements that enhance repricing yield, turnaround time, and savings predictability
Work closely with Sales and Client Management to support go-to-market strategy, pricing models, and client-facing network positioning
Translate network evaluation outcomes into clear internal guidance and external messaging
Partner with Technology and Data teams to define requirements for network performance analytics, benchmarking, and reporting tools
Collaborate with Legal and Compliance to ensure network strategies meet all regulatory and contractual standards
Define and monitor KPIs related to network and sub-network performance, including: Repricing savings and hit rates, Network access and penetration, Provider participation and overlap, Client satisfaction and retention
Use performance insights to drive continuous optimization of network partnerships and product strategy
Qualification
Required
Bachelor's degree required
7–10+ years of experience in healthcare product management, PPO networks, medical bill review, or cost containment
Demonstrated experience evaluating, selecting, and managing PPO networks and sub-networks
Strong understanding of PPO network contracting and fee structures
Strong understanding of medical billing and reimbursement methodologies
Preferred
MBA or advanced degree
Workers' compensation and/or complex reimbursement environments
Company
MedRisk
Founded in 1994 and headquartered in Conshohocken, Pennsylvania, MedRisk was established with a mission to revolutionize physical rehabilitation for workers' compensation patients.
1001-5000 employees
H1B Sponsorship
MedRisk 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
2021 (2)
Funding
Current Stage
Late StageLeadership Team
Srivatsan Sridharan
Chief Executive Officer
Kenneth Martino
Chief Financial Officer
Company data provided by crunchbase