What are the responsibilities and job description for the Remote Manager, Provider Network Contracting- Value-based Care position at Everly Talent?
- Lead end-to-end value-based contracting, including planning, negotiation, execution, and implementation across models such as P4P, shared savings, bundled payments, capitation, and hybrids.
- Partner with finance, clinical, operations, and quality teams to launch agreements, monitor performance against cost, quality, and utilization targets, and support improvement strategies.
- Conduct reimbursement and risk-sharing analytics, evaluate provider proposals, and develop incentive models aligned with MLR and budget requirements.
- Ensure compliance with federal and state regulations (e.g., 42 C.F.R. 422, Medicaid managed care, TRICARE) in collaboration with legal and compliance teams.
Bachelor’s degree required; Master’s preferred, with at least 7 years in managed care, healthcare, or provider relations, including 3 years in management.
Strong knowledge of managed care principles, network development, credentialing processes, provider relations operations, and regulatory requirements.
Advanced analytical abilities with proficiency in provider data, reimbursement methodologies, financial modeling, and interpreting complex performance metrics.
Excellent communication, negotiation, relationship-building, and leadership skills, with ability to collaborate across internal teams and external provider partners.
- Estimated salary range of $94k - 143K DOE along with performance bonuses and a robust benefits package with a 403(b) match
Salary : $94,000 - $143,000