About this role
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
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Network Strategy Development & Execution: Develops and continuously refines Evry Health's provider network strategy — geographic prioritization, contracting targets, payment methodology, and network composition objectives.
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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.
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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.
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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.
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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
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Required
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Bachelor's degree in Business, Healthcare Administration, Economics, or related field
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10+ years in managed care contracting, provider network development, or provider relations
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3+ years in a director-level role managing a network contracting team
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Expertise negotiating multi-methodology (incl. value-based/risk) contracts & SERFF/adequacy compliance
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Preferred
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MBA, Healthcare Administration, or closely related graduate degree
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Experience building a network function from inception at a growth-stage health plan
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Experience in both health plan-side and provider-side contracting roles
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Knowledge of Texas commercial health insurance market & adequacy requirements