Health Plan Services (HPS)
Manager, Contracts
Louisville , KY, United States

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—56.7% in year-over-year revenue growth in 2016. 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.

This position is responsible for managing the preparation, negotiation, and policy development and ongoing changes with regard to contractual materials. (with respect to the provider network)  Will assist in the development of the strategic direction and management of day to day contracting activities for Evolent Health.

 

Principal Accountabilities:

  •   Performs evaluation and execution of provider contracts and amendments for physicians, hospitals, and ancillary providers.
  • Develops and implements procedures for contract management and administration in compliance with company policy; maintains full compliance with DMS contract requirements.
  • Formulates and maintains contracting strategies; creates contracting strategies that factor into consideration medical cost savings based on MLR (Medical Loss Ratio) and PMPM (Per Member/Per Month) costs.
  • Serves as point of contact for providers on contractual matters--ensuring timely review and approval/reconciliation of variations.
  • Maintains contractual records and documentation.
  • Provides guidance for all contractual matters for operational staff; ensures accuracy, appropriateness and timeliness of the work.
  • Educates providers on contract expectations and processes.
  • Performs other duties as assigned.
  • Lives the values: Integrity, Community, Collaboration and Stewardship, as defined in the performance appraisal.
  • Excellent verbal and written communication skills.
  • Effective problem solving skills.
  • Proficient experience using Outlook, Word, Excel and PowerPoint in a Windows operating system.
  • Strong organizational and interpersonal skills.  
  • Other duties as assigned. 
 The Experience You’ll Need (Required):
  • Bachelor’s degree in business or health related discipline such as Healthcare Administration or Healthcare Management preferred.
  • Minimum 3-5 years progressive experience in Business, preferably Healthcare.
  • Minimum 3-5 years Managed Care Experience in Provider Contracting preferred.
  • Medicaid Managed Care Experience preferred
  • HIPAA and NCQA experience preferred.

 

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.

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