Evry Health
Network Relations Specialist
TLDR
Develop and manage a geographic medical network, negotiating contracts with providers, ensuring network adequacy, and collaborating with analytics and IT to optimize medical economics.
Responsibilities
Development of an adequate provider network within assigned geographic markets. Includes Negotiating and renegotiating contracts with physicians and provider groups and facilities
Responsible for collecting roster updates and standardizing information received with Analytics and IT teams
Tracking and coordinating notification of effective date with the credentialing CVO
Maintenance and management of the network in accordance with regulatory time, distance and choice requirements
Building and maintaining relationships with contracted providers, including responding to inquiries related to contract status, roster corrections and matters related to information accuracy
Routinely running and monitoring of various reports to ensure all necessary compliance requirements are being met and maintained, and identifying targets to address emergent gaps
Accurate maintenance of Salesforce or similar contract tracking and activity system
Reporting to leadership the current status, risks, and potential opportunities in area of responsibility on a regular basis
Working with analytics and actuarial team(s), compile and analyze provider and hospital fee schedules to benchmark against goals and assist with the medical economics reporting
Performs other duties as required
Qualifications
Experience negotiating commercial contracts with hospital systems, provider groups
5+ years negotiating provider contracts including physician / provider group contracts with multiple payment methodologies, e.g. percent of Medicare, RBRVS, ICD or similar code set, case rates, DRG, as well may include discussion of value based/risk parameters
Analytic capabilities, including experience with SERFF reporting of network adequacy
Experience with Salesforce or similar contact management system
Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships.
Bonus: Experience in multi-state or national provider contracting
Telecommuting Requirements
Required to have a dedicated work area established that is separate from other living areas and provides information privacy.
Ability to keep all company sensitive documents secure.
Must live in the United States.
Must live in a location that receives an existing high-speed internet connection/service.
Location and Benefits
This is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas.
Company business hours are weekdays 9-5 CST.
Full benefits package including health insurance, 401(k) matching, vision, dental, life, disability, and vacation.
Benefits
Equity Compensation
401(k) matching
Health Insurance
Disability insurance
Disability
Paid Time Off
Vacation
Remote-Friendly
Remote work