Vendor Performance Manager

Job Description: • Manages third party program relationships with Delegation partners for performance management standards • Acts as the critical link between our Delegation partners and internal Departments • Serves as a key account manager for assigned vendors, ensuring effective communication, compliance with contracts, and optimal performance • Manages vendor utilization including work flows for coordinating services with the Health Plan and/or Operations Departments • Provides and shares monthly SLA performance dashboards and/or reporting with Delegated entity and addresses issues in performance of assigned SLA’s • Requests and/or assists in the development of correction action plans for standards that are not met by the vendor and implements correction action plans when necessary • Tracks, analyzes, and reports on vendor performance and opportunities for improvement • Creates and manages vendor scorecard and associated ratings/correction plans • Coordinates with Medical Management, Member Services, and Provider Services to educate and communicate expectations, performance and procedures to vendors • Schedules and conducts monthly meetings with Delegated entities and documents discussions, issues, attendees, and action items • Researches and resolves claim disputes with vendor, member or provider issues and routes to appropriate person(s) for resolution • Ensures operation integrity, including compliance with all policies and procedures for including adherence to state contract and guidelines • Contributes to special projects and other planning initiatives that involve oversight of the Delegated Care Management entities • Performs other duties as assigned Requirements: • Bachelor's Degree in Business Administration, Public Administration or related field or equivalent experience required • 5+ years supporting working with Primary Care Providers • Account Management experience working in Healthcare or related field • Able to present to executive-level teams at the delegated entities Benefits: • competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules Apply Now Apply Now