Network Relations Specialist

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Evry Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2017

⚕️ Healthcare Insurance

🤝 B2B

🧘 Wellness

Healthcare Insurance • B2B • Wellness

Evry Health is a modern, mobile-first health insurance company that provides fully insured employer health plans and personalized care teams. Built for midsize and larger employers (primarily in Texas), Evry offers no-copay, no-deductible plans, 24/7 virtual care, integrated wellness programs, and individualized support from nurses, nutritionists, and doctors to simplify costs and improve employee health. The company emphasizes a human, member-focused approach and digital tools (iOS/Android app) to deliver care and benefits.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• Full benefits package including health insurance • 401(k) matching • vision • dental • life • disability • vacation