Sr. Provider Network Manager

Company: Evolent Health
Location: Jackson
Posted on: January 16, 2022

Job Description:

**This is an unique opportunity to improve the health and wellbeing of millions of Americans!** Founded in 2002, New Century Health has been on the cutting edge of value-based innovation for decades as the nation's foremost specialty care management company, specializing in managing cancer and cardiology patients for both payers and risk-based providers. Formerly backed by Water Street Partners, the company was acquired by Evolent Health in 2018 and has scaled tremendously since. Specifically, New Century Health provides physicians with clinical decision and population health management tools to ensure that their patients receive the highest quality, most affordable care. These best-in-class tools, which have earned the business URAC accreditation in Health Utilization Management and NCQA accreditation in Utilization Management, consistently drive clinical and financial improvements for the two most complex and expensive diseases in the nation. This commitment to excellence has helped spur our success and put us on track to surpass record-breaking year-over-year growth in the coming years. **What You'll Be Doing:** The Sr. Provider Network Manager is primarily responsible for provider engagement which includes performance management and maintaining positive working relationships with all assigned program participating providers. This role serves as the liaison between the provider and New Century Health's internal departments to address and resolve issues as needed. The Sr. Provider Network Manager conducts provider in-servicing which provides a clear interpretation of the organization's policies and procedures related to various administrative/operations functions, in addition to providing continuous provider education to all network providers. Other responsibilities include: + Owning responsibility for network development activities including, but not limited to, assessing strategic market dynamics and plan needs, identifying provider targets while meeting access standards (where applicable), pay for performance, and value based alternative payment models + Tightly managing assigned practices relative to provider performance, analyzing network's quality benchmark results, missed opportunities, cost effectiveness, marketability, stability, and accessibility + Identifying outliers and working closely with other internal departments in strategizing how best to improve performance while minimizing provider abrasion + Taking responsibility for all new market implementation activities related to provider onboarding including, but not limited to, coordination and facilitation of key provider and or client introductory meetings, and deep-dive markets sessions + Managing and helping mitigate specialty leakage by identifying root cause, addressing ways to resolve both internally and through provider and/or health plan education + Meeting with practice leadership regularly to share performance results, identify areas of opportunities for both NCH and the provider, while also deepening relationships at all levels within practices + Training new team members + Representing the company in JOC meetings with current clients **The Experience You'll Need (Required):** + Bachelor's degree + Minimum of 6-9 years relevant work experience + Strong background and deep understanding of fundamental operational processes (such as Claims and Prior Authorization) which directly affect providers and organizations + Excellent verbal, writing, presentation, and interpersonal skills + Extreme organization and detail orientation with exceptional follow through skills + Ability to multi-task in a fast pace environment + Ability to influence change to improve provider experience + Strong knowledge of Microsoft programs (i.e. Word, Excel, SharePoint) + Ability to travel as needed (% depends on market) + Experience in healthcare administration with strong emphasis in Provider Operations and/or Network Development/Provider Contracting strategies **Technical requirements:** Evolent allows employees to work remotely for many of our positions. For those working remotely, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption. **Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. Evolent Health maintains a drug-free workplace. Evolent has been** **named one of "Becker's 150 Great Places to Work in Healthcare" in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts. Evolent achieved a 95% score on its first-ever submission to the Human Rights Campaign's Corporate Equality Index, was named on the Best Companies for Women to Advance List 2020 by Parity.org, and we publish an annual Diversity and Inclusion Annual Report to share our progress on how we're building an equitable workplace. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. 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.**

Keywords: Evolent Health, Jackson , Sr. Provider Network Manager, Executive , Jackson, Mississippi