Director of Product - Network
Nomi HealthRemotely
sqlpricingeligibilitytpanetworkedifecs835837
Job Description
📋 Description
- Market solution design: Partner with network, go-to-market, and sales teams to define and scope
- Partner and TPA data exchange: Write the integration requirements between Nomi and every partner in
- Network configuration and pricing: Own the path from a signed rate sheet to a correctly priced
- Provider data, adequacy, and directory: Own the provider data model and hierarchy — sponsor, tax
- New segments and group types: Evaluate new group types and segments as they come up, be willing to
- The payments interface: Recognize when a network change has payment-side consequences and get ahead
🎯 Requirements
- Reimbursement fluency: You understand the difference between billed, allowed, and paid, and you've
- Domain background: You've built this expertise at a health plan, a TPA, a repricing or
- Data exchange experience: You're comfortable with 837, 835, and eligibility file exchange, and
- Commercial confidence: You're comfortable representing Nomi directly in front of a broker, a TPA
- A self-directed approach: You're comfortable defining your own priorities and figuring out what
- Enough technical fluency to be credible: You can read a data model, write SQL against it, and give
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