Head of Provider Network Strategy
External$120K–$150K/yrFull-timeRemote1d ago
ComplianceCross-functional CollaborationDocumentationLeadershipProcess Improvement
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Responsibilities
- Payer Strategy & Network Growth
- Develop and execute strategies to expand and optimize Finni's payer network.
- Evaluate commercial and Medicaid payer opportunities based on strategic fit, reimbursement potential, and long-term business value.
- Partner with leadership to prioritize payer partnerships that support Finni's growth strategy and provider success.
- Build and maintain strong relationships with payer representatives to improve network access and operational performance.
- Identify opportunities to strengthen existing payer partnerships and improve contract performance.
- Business Operations & Team Leadership
- Lead and develop the team responsible for payer enrollment, contracting operations, and network maintenance.
- Establish KPIs, reporting, and operational processes to drive accountability and operational excellence.
- Ensure provider enrollments are completed accurately and efficiently so providers can successfully become in-network.
- Identify operational bottlenecks and implement scalable solutions that improve speed, quality, and provider experience.
- Manage internal and offshore resources to ensure timely execution and consistent operational performance.
- Build systems and workflows that support rapid provider and market expansion.
- Network Maintenance & Compliance
- Oversee revalidation, recredentialing, roster management, demographic updates, and ongoing payer maintenance activities.
- Ensure all payer deadlines, renewals, and compliance requirements are proactively managed to prevent network lapses.
- Maintain accurate contract documentation, payer records, and operational data.
- Partner with Compliance and Revenue Cycle teams to ensure adherence to payer requirements and regulatory standards.
- Prepare and present operational data, compliance metrics, and network performance reporting for internal leadership and payer partners.
- Support payer audits, escalations, and operational issue resolution.
- Business Performance & Process Improvement
- Own operational metrics related to payer enrollment, network growth, revalidation, and team performance.
- Analyze operational data to identify trends, improve workflows, and support strategic decision-making.
- Lead initiatives that improve scalability, reduce administrative burden, and enhance provider satisfaction.
- Collaborate with Product and Operations teams to improve internal systems and automate manual processes where possible.
- Drive continuous improvement efforts that increase efficiency and support Finni's long-term growth.
- Cross-Functional Collaboration
- Partner closely with Credentialing, Revenue Cycle Management, Provider Success, Product, Compliance, Finance, and Executive Leadership teams.
- Serve as the operational owner for initiatives involving payer network growth and provider onboarding.
- Align stakeholders around strategic initiatives that improve network access, operational efficiency, and provider success.
- Contribute to special projects and evolving responsibilities as Finni Health continues to grow.
- About You
- You are a strategic, execution-oriented operations leader who enjoys building scalable systems and solving complex operational challenges. You thrive in fast-paced environments, use data to drive decisions, and know how to balance day-to-day execution with long-term business strategy.
Requirements
- 4+ years of experience in healthcare operations, payer operations, network management, revenue cycle operations, credentialing, provider enrollment, or a related healthcare function.
- Experience working with commercial and Medicaid payers is required.
- Experience with payer contracting, provider enrollment, revalidation, and network maintenance is strongly preferred.
- Experience in behavioral health, ABA, mental health, healthcare services, or h
Benefits
Health insurance
Additional Information
About Finni Health Finni Health empowers autism care providers to start, run, and grow their own practices. We democratize autism care by providing access to our insurance network, purpose-built EHR software, HR solutions, and clinical support. We've experienced rapid growth and are backed by top-tier investors like General Catalyst and Y Combinator. We seek smart, driven individuals eager to innovate in a dynamic, fast-paced environment.
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