Director of Network Relations

Team: Medical Policy and UM

Location: Remote

Commitment: Full-Time

Workplace Type: remote

Responsibilities

• Network Strategy Development & Execution: Develops and continuously refines Evry Healths 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 Healths 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
Bachelors 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