Vice President, Provider Network Contracting

Evolent Health - Remote3.6

Full-timeEstimated: $120,000 - $170,000 a year
It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely—70.3% in year-over-year revenue growth in 2017. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016 and 2017, and one of the “50 Great Places to Work” in 2017 by Washingtonian, and our CEO was number one on Glassdoor’s 2015 Highest-Rated CEOs for Small and Medium Companies. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

The Job:
Evolent Health is looking for a Vice President, Provider Network Contracting to be responsible for providing leadership and input into the enterprise-wide strategic direction and tactical leadership for Network Development, Provider Contracting, Provider Data Management and Provider Relations. The position supports the SVP, Provider Network Contracting in accountability and responsibility for provider network maintenance and adequacy nationally and in the direction of all activities related to provider relations, contracting, provider education and communications and provider data integrity. The position supports the SVP, Provider Network Contracting in leading the development of systems and processes that maintain positive relations with providers, while meeting the strategic business needs of Evolent Health.

What You’ll Be Doing:
Providing leadership and direction for local market client provider relations activities and staff including contracting and provider database management;
Developing and coordinating provider education regarding various product lines;
Ensuring provider negotiations and contracts are managed in a way that is in compliance with various regulatory agencies
Supporting the development of provider relations plans and strategies that support company goals and objectives
Directing necessary activities with Third Party Administrators (TPAs) to ensure connection between provider relations and claims management
Working in concert with key areas at Evolent to provide necessary information for claims payment, and provider data maintenance
Assisting in the development of reimbursement strategies that are aligned with EVH objectives and also meet the demands of the provider community
Monitoring provider contract performance to ensure appropriate financial objectives are being satisfied
Providing oversight and monitoring of network adequacy requirements within the established contracted networks
Monitoring department performance measures, and quality improvement activities
Supporting the provision of coaching and training for staff to ensure a continuous learning environment
Performing other duties as assigned

The Experience You’ll Need (Required):
10-15 years of progressive leadership in managed care, with a minimum of 8 years in managed care administration and operations
Strong understanding of the healthcare industry, managed care and Provider financing
Experience in contracting with large, complex Provider organizations
Documented success in Provider contracting, recruitment, retention, and service
Exceptionally high “Emotional Intelligence” – able to connect with diverse constituents, actively
listen, and identify key areas of sensitivity
Demonstrated ability to communicate, present and influence credibly and effectively at all levels
of the organization, including executive and C-level
An entrepreneurial spirit as we continue to build the national platform for Network Contracting
A steady demeanor with the judgement to determine when to escalate and how to prioritize
competing inputs
Excellent listening, negotiation and presentation skills
Excellent verbal and written communications skills, particularly in the realm of telling a
compelling story of value contributed to the partners, providers, and other key stakeholders
Bachelor’s degree required; Master’s degree preferred (MBA, JD, etc.)

Finishing Touches (Preferred):
Experience with government programs
Knowledge of Medicaid and Medicare reimbursement methodologies
Collaborative working style with the ability to lead and work across different organizations in a matrix environment
Strong sense of ethics, “roll-up sleeves” attitude, and good sense of humor

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.