Director of Network Relations

Evry Healthcare Inc.; United States; Remote; USD 180,000 - 260,000; Full time

Job summary

Evry Health seeks a Director of Network Relations to lead the provider network across fully insured markets, owning strategy, adequacy compliance, and complex contract negotiation with value-based design.

The role directs the Network Relations team, oversees SERFF filings, and collaborates on fee schedules, delivering executive-level performance insights to the CMO and leadership.

Qualifications

• Bachelor's degree required in specified fields.
• 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 contracts including value-based/risk and SERFF/adequacy compliance.

Responsibilities

• Develops and refines provider network strategy including geographic prioritization, contracting targets, payment methodology, and network composition objectives.
• Leads and coaches the Network Relations team, setting territory objectives and providing strategic guidance on complex contracting situations.
• Personally leads high-value provider contract negotiations and designs value-based contracting models aligned with quality outcomes.
• Maintains executive oversight of network adequacy monitoring and SERFF filing activity, serving as primary regulator contact on adequacy matters.
• Partners with Actuarial on fee schedule benchmarks and delivers executive-ready network performance reports.

Skills

Network strategy

Contract negotiation

Leadership

SERFF compliance

Education

Bachelor's degree in Business, Healthcare Administration, Economics, or related field

Job 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