Senior Manager, Provider Network Operations

Pomelo Care

2d • $130,000 - $150,000 • Remote

About The Position

Pomelo Care is a virtual medical practice for women and children, providing care across pregnancy, postpartum, pediatrics, menopause, and perimenopause. The Senior Manager of Provider Network Operations will build and scale the clinical network supporting Pomelo’s new Midlife line of business. The role partners with Recruiting, Licensing and Credentialing, Product, Clinical Leadership, and other teams to develop processes, programs, and infrastructure that support network growth, utilization, retention, and quality as volume scales.

This position owns the provider relationship from orientation through utilization and retention, establishes network capacity and utilization measures, and uses reporting and data to identify issues and drive improvements. It also works with Quality and Clinical leadership to define network participation standards, monitor provider-level quality, respond to outliers, and support remediation or contract termination when necessary. The role represents the provider network in company-wide planning and flags risks before they become urgent.

Pomelo describes itself as a fast-moving, well-funded, mission-driven startup focused on putting patients first. The position is fully remote within the United States, with the option to work in person at the New York or San Francisco offices.

Requirements

• At least 5 years of experience in provider network management, provider success or experience, or network operations at a telehealth company.
• Demonstrated ownership of key network metrics, including growth, retention, utilization, and quality.
• Ability and interest in building new processes as well as optimizing existing ones.
• Strong cross-functional communication skills and ability to work with Clinical, Product, Compliance, and Commercial teams and translate between them.
• Strong analytical skills and a track record of using data to tell a story and prioritize investments.
• Comfort with ambiguity and an early-stage pace.

Nice To Haves

• Experience in women's health.
• Experience with a clinician network involving multiple license types, such as MDs, NPs, and RDs.

Responsibilities

• Set and report on network capacity targets and identify and close gaps before they affect patient access.
• Partner with Recruiting, Licensing and Credentialing, and Learning teams to keep the time from contract signature to first patient visit efficient as volume scales.
• Own the end-to-end provider relationship, including orientation, utilization, and retention across the network.
• Define and track provider utilization metrics and turn insights into concrete process or product improvements.
• Build and run programs, such as incentives and community initiatives, that keep clinicians actively practicing within the Pomelo network.
• Partner with the Quality team to define network quality standards and translate clinical quality standards into network participation criteria.
• Monitor provider-level quality data, including utilization, patient outcomes, and complaints, and drive action on outliers with Clinical leadership.
• Support quality-based remediation and, when necessary, contract termination decisions in accordance with Pomelo’s clinical and compliance standards.
• Coordinate across Licensing, Credentialing, Quality, Clinical Operations, and Product teams that support the clinical network.
• Build reporting and dashboards that provide a clear view of network health.
• Represent the provider network in company-wide planning and flag risks, including capacity gaps and quality issues, before they become urgent.

Benefits

• Comprehensive health, dental, and vision coverage for employees and their families.
• High-deductible health plans with Health Savings Account (HSA) options.
• Flexible Spending Account (FSA).
• Equity grant participation.
• 401(k) program.
• Competitive vacation policy.
• 16 weeks of paid parental leave.
• Fully remote work flexibility within the United States, with the option to work in person at the New York or San Francisco offices.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed