Director of Network Relations

This is a fully remote position, open to applicants in United States.

📋 Description

• Formulate and continuously enhance Evry Health's strategy for provider networks, encompassing geographic prioritization, contracting targets, payment methodologies, and network composition goals.

• Direct, mentor, develop, and manage the performance of the Network Relations team.

• Establish territory objectives and offer strategic insight on intricate contracting scenarios.

• Personally conduct negotiations for high-value, strategically important provider contracts.

• Create innovative value-based contracting models that align provider incentives with quality outcomes.

• Supervise the monitoring of network adequacy and the activities related to SERFF filing.

• Act as Evry Health's main point of accountability to regulators regarding network adequacy issues.

• Collaborate with the Actuarial team on fee schedule benchmarks and rate objectives.

• Provide regular, executive-ready reports on network performance to the CMO and leadership team.

⛳️ Requirements

• Bachelor's degree in Business, Healthcare Administration, Economics, or a related discipline.

• Over 10 years of experience in managed care contracting, provider network development, or provider relations.

• More than 3 years in a director-level position overseeing a network contracting team.

• Proficiency in negotiating multi-methodology (including value-based/risk) contracts and ensuring SERFF/adequacy compliance.

• MBA, Healthcare Administration, or a closely related graduate degree is preferred.

• Experience in establishing a network function from the ground up at a growth-stage health plan is preferred.

• Background in both health plan-side and provider-side contracting roles is preferred.

• Familiarity with the Texas commercial health insurance market and its adequacy requirements is preferred.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance plans.

• Generous paid time off and holiday schedule.

• Opportunities for professional development and continued education.

• Collaborative and innovative work environment.