This role is fully remote and must be located within one of the contiguous 50 states.

You'll join Devoted's Network team, which builds and supports the provider networks that care for more than 538,000 Medicare Advantage members, and which is expanding to 1,341 counties across 34 states in 2027.
As VP, Network Performance, you'll own the operational backbone of our network: provider data in order to inform performance decisions. Where our contracting teams negotiate agreements, you'll make sure they work in practice for members, providers, and claims and it will be equally important to use data to direct contracting and recontracting efforts across all markets.
This is a builder's role. You'll scale a performance management operation that oversees thousands of providers, replacing manual work with automated, data-driven processes.
You'll report to the [SVP / Chief Network Officer], lead a team and partner closely with Network Contracting, Engineering, Claims, Compliance, Finance, and Devoted Medical.

12+ years of health plan or managed care experience, including 7+ years leading provider network operations functions such as provider data management, contract configuration, credentialing, or provider service.
5+ years of senior leadership experience managing multi-layered teams (directors and managers) and external vendor or BPO partners.
Deep knowledge of Medicare Advantage network requirements, including CMS network adequacy standards and HSD submissions, provider directory requirements (including Medicare Plan Finder submissions), NCQA credentialing standards, and audit readiness.
Demonstrated experience translating complex provider contracts and payment methodologies (fee-for-service, capitation, and value-based arrangements) into accurate claims configuration.
Proven record of improving operational KPIs through process redesign, data governance, and technology; Bachelor's degree or equivalent combination of education and experience.

Experience scaling network operations through multi-state expansion at a high-growth or technology-enabled health plan, including D-SNP and C-SNP products.
Hands-on experience implementing provider data management or MDM platforms, roster automation, AI or RPA solutions, and FHIR-based provider directory standards.

Set the vision, roadmap, budget, staffing model, and vendor strategy for Network Operations, aligned with Devoted's market expansion plans and annual CMS bid cycles, and build a high-performing team.
Ensure every negotiated agreement (fee-for-service, capitated, and value-based) is loaded and configured accurately for claims payment, reducing contract-to-configuration cycle times and payment errors in partnership with Claims and Payment Integrity.

This role is fully remote and must be located within one of the contiguous 50 states.

You'll join Devoted's Network team, which builds and supports the provider networks that care for more than 538,000 Medicare Advantage members, and which is expanding to 1,341 counties across 34 states in 2027.
As VP, Network Performance, you'll own the operational backbone of our network: provider data in order to inform performance decisions. Where our contracting teams negotiate agreements, you'll make sure they work in practice for members, providers, and claims and it will be equally important to use data to direct contracting and recontracting efforts across all markets.
This is a builder's role. You'll scale a performance management operation that oversees thousands of providers, replacing manual work with automated, data-driven processes.
You'll report to the [SVP / Chief Network Officer], lead a team and partner closely with Network Contracting, Engineering, Claims, Compliance, Finance, and Devoted Medical.

12+ years of health plan or managed care experience, including 7+ years leading provider network operations functions such as provider data management, contract configuration, credentialing, or provider service.
5+ years of senior leadership experience managing multi-layered teams (directors and managers) and external vendor or BPO partners.
Deep knowledge of Medicare Advantage network requirements, including CMS network adequacy standards and HSD submissions, provider directory requirements (including Medicare Plan Finder submissions), NCQA credentialing standards, and audit readiness.
Demonstrated experience translating complex provider contracts and payment methodologies (fee-for-service, capitation, and value-based arrangements) into accurate claims configuration.
Proven record of improving operational KPIs through process redesign, data governance, and technology; Bachelor's degree or equivalent combination of education and experience.

Experience scaling network operations through multi-state expansion at a high-growth or technology-enabled health plan, including D-SNP and C-SNP products.
Hands-on experience implementing provider data management or MDM platforms, roster automation, AI or RPA solutions, and FHIR-based provider directory standards.

Set the vision, roadmap, budget, staffing model, and vendor strategy for Network Operations, aligned with Devoted's market expansion plans and annual CMS bid cycles, and build a high-performing team.
Ensure every negotiated agreement (fee-for-service, capitated, and value-based) is loaded and configured accurately for claims payment, reducing contract-to-configuration cycle times and payment errors in partnership with Claims and Payment Integrity.

VP Network Operations

Skills