• Job Description

  Req#: JR-911330

  Your Future Evolves Here

  Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

  Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

  Join Evolent for the mission. Stay for the culture.

  What You’ll Be Doing:

  Put your passion where it meets purpose! We are hiring for a Provider Relations Manager who is responsible for building and maintaining a professional and positive working relationship with, but not limited to, CEOs, CFOs, Medical Directors, Director of Nursing, Clinical Leadership, Participating Providers, Prior Authorization Staff, Client Representatives, etc. This person will also serve as the liaison between the provider and Evolent’s internal departments to address and resolve issues as needed.

  Collaboration Opportunities:

  Support and Development

  • Develop and promote a positive perception of Evolent to enable a customer-oriented, collegial partnership.
  • Conduct provider in-services and educate clients during new client implementations, supporting office staff on process/delivery system and company policies and procedures within the established time frames and thereafter as necessary, either on-site, telephonic, or via webinars.
  • Provide in-depth monthly/quarterly program reviews with CEOs, CFOs, Medical Directors, Director of Nursing, Clinical Leadership, Participating Providers, Prior Authorization Staff, Client Representatives, etc.
  • Handle incoming provider calls, documenting (in CRM), and resolving issues.
  • Responsible for developing and maintaining provider orientation/in-service educational materials and clinical checklists and tip sheets for assigned client provider networks.
  • Utilize only company-approved educational materials that conform and follow all State, CMS, or any other applicable regulatory agencies.
  • Communicate any updates to network providers in a timely matter. Take the front line in establishing and maintaining strong communications with providers.
  • Identify opportunities for promoting broader use of Web portals, RadMD and CarePro and proactively communicate with providers not taking full advantage of the tool.
  • Respect and maintain HIPAA confidentiality guidelines.

  Operations and Leadership

  • Take the lead in responding to and resolving provider issues; facilitate problem-solving with other internal operations stakeholders and client provider relations personnel to achieve a fair resolution and positive outcome whenever and wherever possible with providers; and/being proactive in communicating with high-impact providers in each market to ensure that the highest provider satisfaction levels are achieved, and client appreciation is gained as a result.
  • Routinely monitor provider performance to target and perform remedial training sessions based upon area of need (e.g., authorization processes, claims submissions, etc.).
  • Interact and participate with other departments to accomplish company-wide goals and objectives.
  • Act as an interdepartmental liaison between all Evolent offices, departments, and committees.

  Qualifications – Required and Preferred:

  • Bachelor’s degree or three (3) plus years’ experience in healthcare with a strong emphasis in Provider Relations and/or Network Development (Required)
  • Must have strong knowledge of managed care terminology (Required)
  • Broad knowledge of delivery systems and related industry terms (Required)
  • Solid knowledge of health plan operations (Required)
  • Excellent verbal, writing, and presentation skills (Required)
  • Excellent people skills (Required)
  • Extremely organized and detail-oriented with exceptional follow-through skills (Required)
  • Ability to multi-task in a fast-paced environment (Required)
  • Can adapt quickly to change (Required)
  • Ability to conduct physician in-servicing (training sessions) (Required)
  • Excellent relationship building skills (Required)
  • Must have knowledge of Microsoft programs (i.e., Word, Excel, PPT) (Required)
  • Able to travel as needed (Required)

  Technical Requirements:

  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 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. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.

  The expected base salary/wage range for this position is $75,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.

• About the company

  Evolent partners with payers and providers to dramatically reduce the total cost of care, improve clinical quality and simplify administration.

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