About the RoleEvry Health, a Globe Life company, is seeking a Network Relations Specialist. In this role, you will lead the development and management of a geographic medical network for our health plan. You will negotiate, review and amend contracts with physicians, physician groups, facilities, and ancillary medical providers. We are big believers in partnering for improved medical quality, so contracts may be value-based. You will also be responsible for monitoring and reporting network adequacy and network quality. About Evry Health and Globe LifeWe are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives.Evry Health is the major medical division of Globe Life (NYSE:GL). Globe Life has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company.ResponsibilitiesDevelopment of an adequate provider network within assigned geographic markets. Includes Negotiating and renegotiating contracts with physicians and provider groups and facilitiesResponsible for collecting roster updates and standardizing information received with Analytics and IT teamsTracking and coordinating notification of effective date with the credentialing CVOMaintenance and management of the network in accordance with regulatory time, distance and choice requirementsBuilding and maintaining relationships with contracted providers, including responding to inquiries related to contract status, roster corrections and matters related to information accuracyRoutinely running and monitoring of various reports to ensure all necessary compliance requirements are being met and maintained, and identifying targets to address emergent gapsAccurate maintenance of Salesforce or similar contract tracking and activity systemReporting to leadership the current status, risks, and potential opportunities in area of responsibility on a regular basisWorking with analytics and actuarial team(s), compile and analyze provider and hospital fee schedules to benchmark against goals and assist with the medical economics reportingPerforms other duties as requiredQualifications Experience negotiating commercial contracts with hospital systems, provider groups5+ years negotiating provider contracts including physician / provider group contracts with multiple payment methodologies, e.g. percent of Medicare, RBRVS, ICD or similar code set, case rates, DRG, as well may include discussion of value based/risk parametersAnalytic capabilities, including experience with SERFF reporting of network adequacyExperience with Salesforce or similar contact management systemExcellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships.Bonus: Experience in multi-state or national provider contractingTelecommuting RequirementsRequired to have a dedicated work area established that is separate from other living areas and provides information privacy.Ability to keep all company sensitive documents secure.Must live in the United States.Must live in a location that receives an existing high-speed internet connection/service.Location and BenefitsThis is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas.Company business hours are weekdays 9-5 CST.Full benefits package including health insurance, 401(k) matching, vision, dental, life, disability, and vacation.
