Director of Network Relations
Posted Updated 3
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Description
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
Skills
As published by lever · 4 questions
Basics
Resume/CV, Full name, Email, Phone, Current location, Current company, LinkedIn URL, Portfolio URL, Evry Health
Short answers (1)
- Please specify your desired salary range (do not answer with just negotiable)
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- Do you currently reside in the United States and in CST or EST time zone? optional
- Are you legally authorized to work in the United States? optional
- Will you now, or in the future, require sponsorship for employment visa status (e.g. H-1B visa status)? optional