Director of Product – Network

Job not on LinkedIn

🔥 12 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🔴 Lead

✅ Product Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 11%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Nomi Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2020

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 $110M Series A on 2021-12

Healthcare • Consulting • Logistics

Nomi Health is a company focused on transforming the healthcare system to be more accessible and affordable for everyone. They provide various services and solutions, including direct healthcare services, pharmacy management, analytics, and financial services. Their direct network connects buyers, providers, and patients to eliminate complexity and reduce costs in the healthcare system. Nomi Health works with employers, governments, and other partners to manage healthcare expenses through their digital-first and real-time solutions. They aim to simplify healthcare economics and provide better access to care.

📋 Description

• Partner with network, go-to-market, and sales teams to define and scope Nomi’s deliverables in each new market, including provider coverage, TPA capability, and integration sequencing • Write integration requirements between Nomi and partners across the claim lifecycle, including inbound claims, priced output, remittance, eligibility, file cadence, SLAs, and reconciliation • Own network configuration and pricing from signed rate sheet through correctly priced claim, including ingestion, normalization, versioning, effective dating, validation, and audit • Set testing and release standards for pricing-related changes • Own the provider data model and hierarchy, including sponsor, tax ID, billing NPI, and service location • Make network adequacy and directory accuracy measurable • Evaluate new group types and market segments and recommend against those that do not fit • Identify payment-side consequences of network changes and coordinate with financial services and payments teams

🎯 Requirements

• Hands-on understanding of billed, allowed, and paid amounts • Experience with fee schedules and rate methodologies, including percent-of-Medicare, per diem, case rate, DRG, and percent-of-charge • Domain background at a health plan, TPA, repricing or payment-integrity vendor, reference-based-pricing administrator, provider revenue-cycle organization, or network contracting organization • Experience with 837, 835, and eligibility file exchange • Ability to write successful integration requirements • Comfort representing Nomi directly to brokers, TPA executives, or health systems • Self-directed ability to define priorities without a pre-built roadmap • Ability to read a data model and write SQL • Ability to provide clear direction to engineers; production coding is not required • Strong written communication skills • Preferred: experience in self-funded employer health, including TPA administration, direct contracting, reference-based pricing, or captives • Preferred: platform migration or vendor claims-system implementation experience • Preferred: founder or early-operator background, or experience using automation and AI to replace manual operational work