Healthcare & Clinical
Sr Provider Network Manager
spokane, WA, United States

It’s Time For A Change…

Your Future Evolves Here

At New Century Health we are pioneering a new era of specialty care, focused on engaging with payers and providers to improve the quality of care for patients diagnosed with cancer and heart disease. Our evidence-based care delivery model supports patients during their most vulnerable times, a responsibility we are both humbled by and passionate about. 

With nearly two decades of proven results in Oncology and Cardiovascular care, New Century Health improves quality and lowers costs for the 6M+ patients whose care we manage. Our approach is based on a proven clinical model that engages Oncology and Cardiovascular specialists through value-based care delivery. We believe the highest quality care is also the lowest cost care over time, improving outcomes and delivering financial savings to our partners. The New Century Health model has been proven across Medicare, Medicaid, and Commercial populations. New Century Health joined the Evolent Health family in 2018, joining the mission to change the health of the nation.   

Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were 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.


What You’ll Be Doing:

The Sr. Provider Network Manager is primarily responsible for provider engagement which includes contracting, performance management, and maintaining positive working relationships with all assigned program participating providers. This role serves as the liaison between 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 organization’s policies and procedures related to various administrative/operations functions. Provides continuous provider education to all network providers. Other responsibilities include:

  • Responsible 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, negotiate market competitive provider agreements including fee for service schedules, pay for performance, value based alternative payment models and single case agreements.
  • Tightly manages assigned practices relative to provider performance, analyzing network’s quality benchmark results, missed opportunities, cost effectiveness, marketability, stability, and accessibility.
  • Identifies outliers and works closely with other internal department in strategizing how best to be improve performance while minimizing provider abrasion.
  • Responsible for all new market implementation activities related to provider onboarding, to include but not limited to, coordination and facilitation of key provider and or client introductory meetings, and deep-dive markets sessions.
  • Manages and helps mitigate specialty leakage by identifying root cause, addresses ways to resolve both internally and through provider and/or health plan education.
  • Meets with practice leadership regularly to share performance results, identifies areas of opportunities for both NCH and provider, while deepening relationships at all levels within practice.
  • Trains new team members.
  • Represents the company in JOC meetings with current clients.

The Experience You’ll Need (Required): 

  • Bachelor’s degree or equivalent work experience
  • 6+ years relevant work experience
  • Strong background with deep understanding of fundamental operational processes which directly affect providers and organization such as Claims and Prior Authorization
  • Excellent verbal, writing and presentation skills, and interpersonal skills
  • Extremely organized and detail oriented with exceptional follow through skills
  • Ability to multi-task in a fast pace environment; can adapt quickly to change
  • 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
  • Strong negotiations skills

Touches (Preferred):

  • Bilingual English/Spanish preferred

 

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such 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. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

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.
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