Evry Health

Evry Health is a modern health insurance company that prioritizes delivering great benefits at affordable prices. They offer a unique approach to health insurance by focusing on making members healthier and happier through personalized care from a dedi...

Insurance

Financials

11-50 (15)

Founded 2017

$7M raised

5 open positions

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Network Relations Specialist

4 weeks, 1 day ago

United States

Full-time

Senior

Account Manager

Sales and Business Development

Salesforce

Apply Now

Evry Health

Insurance

11-50

Founded 2017

$7M raised

View All Jobs 5

Description

Develop an adequate provider network across assigned geographic markets.
Negotiate and renegotiate contracts with physicians, provider groups, facilities, and ancillary providers.
Collect roster updates and standardize information with Analytics and IT teams.
Coordinate effective dates and credentialing notifications with the credentialing CVO.
Maintain network compliance with regulatory time, distance, and choice requirements.
Build and maintain relationships with contracted providers and respond to contract and roster inquiries.
Run and monitor reports to ensure compliance requirements are met and identify network gaps.
Maintain accurate records in Salesforce or a similar contract tracking system.
Report network status, risks, and opportunities to leadership on a regular basis.
Compile and analyze provider and hospital fee schedules with analytics and actuarial teams to support benchmarking and medical economics reporting.

Requirements

5+ years of experience negotiating provider contracts, including physician and provider group contracts.
Experience negotiating commercial contracts with hospital systems and provider groups.
Experience with multiple payment methodologies, such as percent of Medicare, RBRVS, ICD or similar code sets, case rates, and DRG.
Experience discussing value-based or risk-based contract parameters.
Analytical experience, including SERFF reporting of network adequacy.
Experience with Salesforce or a similar contact management system.
Excellent verbal and written communication skills.
Ability to develop and maintain effective working relationships.
Bonus: experience in multi-state or national provider contracting.
Must live in the United States and have access to a dedicated private work area with high-speed internet.

Benefits

Remote position with a fully distributed company.
Company headquarters in Dallas, Texas.
Business hours are weekdays 9-5 CST.
Full benefits package including health insurance, vision, dental, life, and disability coverage.
401(k) matching.
Vacation time.

Interested in this position?

Apply directly on the company website

Apply Now

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