Role Summary
The Director of Network Relations leads Evry Health's provider network function across all fully insured commercial health plan markets — owning network strategy, adequacy compliance, and complex contract negotiation, including value-based arrangement design that aligns provider incentives with quality and cost outcomes.
Role Summary
The Director of Network Relations leads Evry Health's provider network function across all fully insured commercial health plan markets — owning network strategy, adequacy compliance, and complex contract negotiation, including value-based arrangement design that aligns provider incentives with quality and cost outcomes.
Role Summary
The Director of Network Relations leads Evry Health's provider network function across all fully insured commercial health plan markets — owning network strategy, adequacy compliance, and complex contract negotiation, including value-based arrangement design that aligns provider incentives with quality and cost outcomes.
Responsibilities
Network Strategy Development & Execution: Develops and continuously refines Evry Health's provider network strategy — geographic prioritization, contracting targets, payment methodology, and network composition objectives.
Team Leadership & Territory Oversight: Leads, coaches, develops, and performance-manages the Network Relations team, setting territory objectives and providing strategic guidance on complex contracting situations.
Complex Contract Negotiation & Value-Based Design: Personally leads high-value, strategically significant provider contract negotiations and designs innovative value-based contracting models that align provider incentives with quality outcomes.
Network Adequacy Oversight & Regulatory Compliance: Maintains executive-level oversight of network adequacy monitoring and SERFF filing activity, serving as Evry Health's primary point of accountability to regulators on adequacy matters.
Fee Schedule Governance & Leadership Reporting: Partners with Actuarial on fee schedule benchmarks and rate targets, and delivers regular executive-ready network performance reports to the CMO and leadership team.
Qualifications
Required
Bachelor's degree in Business, Healthcare Administration, Economics, or related field
10+ years in managed care contracting, provider network development, or provider relations
3+ years in a director-level role managing a network contracting team
Expertise negotiating multi-methodology (incl. value-based/risk) contracts & SERFF/adequacy compliance
Preferred
MBA, Healthcare Administration, or closely related graduate degree
Experience building a network function from inception at a growth-stage health plan
Experience in both health plan-side and provider-side contracting roles
Knowledge of Texas commercial health insurance market & adequacy requirements
Bachelor's degree in Business, Healthcare Administration, Economics or related field; 10+ years managed care contracting or provider network development; 3+ years director-level managing a network contracting team; expertise in value-based contracts and SERFF/adequacy compliance.
Key Responsibilities
- developing network strategy
- negotiating contracts
- leading team
Job Details
- Category: Business Operations
- Seniority: Senior Level
- Commitment: Full Time
- Workplace: Remote — United States
- Languages: English
About Evry Health
A health plan company managing provider networks and value-based care. — Industry: Healthcare