Sr. Vendor Manager, Remote

Job Summary

The Sr Vendor Manager is accountable for managing Tier 1 vendor programs and relationships for all functional lines of business to include Clinical/reputed company and traditional indirect vendor contracts. Tier 1 vendors encompass approximately 100 contracts worth $200M per Sr Vendor Manager. This role partners with the business to focus on developing a program's objectives, strategy and benchmark/scorecard items to ensure vendors meet KPIs. The key responsibilities include oversight of vendor program performance and relationships as well as integration of activities between vendor companies and business partners. The Sr Vendor Manager will ensure resolution of issues and/or implementation of process improvements.

Essential Functions

Contract Management, Program & Performance Management & Reporting:

Responsible for monitoring program performance, including but not limited to the vendors adherence to established SLA's, ROI.

Contribute to the development and maintenance of vendor program performance scorecards

Coordinate regular vendor meetings with internal business partners to facilitate sharing and monitoring of operational performance, service level agreements, compliance, and process improvement opportunities

Coordinate with vendors to maintain appropriate reporting; identifying metrics that will reflect complete and accurate program performance

Responsible for monitoring and consulting with business partners overall performance of the program per agreed upon contract terms, annual budget and business strategy

Program Management

Accountable for ensuring program performance per contract terms and developing renewal strategy to ensure company remains advantaged.

Manage program financials against budget target. Assess financial risk and make recommendations against those risks.

(50%)

Strategy Development, Integration and Execution:

Facilitate vendor deep dive strategy/scorecard meetings quarterly with key internal partners and the vendor.

Translate business strategies into tactical application for vendor management.

Coordinate with IT to establish and maintain vendor bi-directional data feeds and sunset when appropriate

Participate as a SME in projects to assist with development of business and system requirements and ensure vendor processes and systems align with our operations and regulatory requirements

(25%)

Operational Support/Issue Management:

Support the issue management process to ensure timely and accurate resolution of issues.

Act as a liaison with external and internal business partners for issues resolution

Work collaboratively with other areas to address process issues or program enhancements

Provide support and resolution for member and provider escalations.

Ensure member and provider satisfaction by understanding grievances & appeal processes of the vendors, ensuring timeliness of reviews and monitoring overturn rates.

Reporting of resolution and research of critical inquiries aligned with the vendor issue management process.

Act as direct liaison between the vendor partner, issue management team, and internal business partners to drive resolution of issues and underlying causes of the issues.

(20%)

Regulatory Compliance:

Support BEIC & TPRM with corporate compliance, legal, and regulatory requirements for vendor agreements.

Supports completion of corporate compliance requirements, training and annual due diligence requirements (i.e. FWA, VSA, licensure, annual questionnaire).

Gather remediation documents and coordinate with the LOB to ensure completion, then submit to the audit team for final review

Facilitate calls and outreach to non-responsive vendors

Coordinate monthly CMS audit data collection and quarterly audits; and remediation of identified deficiencies.

Collaborate with Compliance areas in the implementation of specific requirements for membership such as CMS .

Enforcement and operational integration of regulatory and Accreditation (Medicare, HEDIS) requirements.

(5%)

Qualifications

Required Work Experience

6+ years related work experience. Experience Details:

Required Management Experience

No supervisory/management experience required

Required Education

Related Bachelors degree or additional related equivalent work experience

Additional Required Qualifications

Contract negotiation experience

Knowledge of health care industry and business related processes

Working knowledge of various components of the Medicare business

Ability to understand and integrate external entities business models with reputed company

Ability to build and maintain strong business relationships

Analytical and financial acumen, learning agility competency, collaboration skills, integration skills, and project management skills

Strong written and verbal communication skills

Ability to interact (with positive results) with a broad spectrum of internal and external individuals and departments

Additional Preferred Qualifications

Project Management