Network Optimization Lead

Location: Remote – US-based candidates only, no visa sponsorship available.

About the role

This role will lead operational priorities where safety, quality, compliance, and execution discipline are central to success. You will collaborate with field leadership, support functions, and cross-functional stakeholders to improve accountability, service delivery, and operational consistency. The position offers the opportunity to influence operational scale, customer outcomes, and organizational performance within a healthcare environment.

Responsibilities

• Contribute to provider network strategy for Illinois Medicaid, focusing on contracting and value-based care models
• Analyze internal and external data and market intelligence
• Monitor network adequacy data to inform contracting opportunities and resolve terminations
• Manage execution of provider network strategic plans to align with operational goals
• Lead governance meetings to ensure compliance with state regulations and support network operations
• Monitor performance against contractual commitments and collaborate to improve efficiencies
• Solve complex challenges related to network adequacy

Requirements

• Bachelor’s degree and 5 years experience in Medicaid operations, network contracting, or network development; or 7 years experience in lieu of degree
• 2+ years in provider relations
• 2+ years with Power BI and Excel for data analysis
• Reside in the State of Illinois

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off including holidays and parental leave
• Short-term and long-term disability
• Life insurance
• Other personal wellness and healthcare benefits

Pay

$115,200 – $158,400 annually