Vendor Manager

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32

Health

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Who We Are
Point
32

Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point
32

Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, lie, and work.

Job Summary
The Provider Vendor Manager supports sourcing, contract execution, and performance management for key vendor partners, including but not limited to Dental, Vision, Durable Medical, Transportation, Hearing, and other Medicare supplemental benefits. The Manager of Vendor Oversight is responsible for relationship management with assigned ancillary providers/vendors, as well as the contractual performance and maintenance of the vendor to ensure compliance, performance, and accurate payment.

Builds relationships with internal vendor business owners across all lines of business.

Job Description

Strategy & Product Development

• Contractual performance and oversight. Work with internal business partners in the management of vendor Service Level Agreements and Performance Guarantees. This includes receiving vendor reports, arranging and attending Joint Operating meetings, reviewing, and documenting vendor performance and assessing corrective actions where applicable.
• Collaborate with internal and external business partners on the collection, analysis, and maintenance of relevant data.
• Strategy and development - Support the development of plans and operational solutions to address changes to vendor programs on an annual basis.

Vendor Contracting

• Work with finance and internal business owners to analyze ROI of various vendors.
• In partnership with Product Leaders, evaluate, negotiate, and recommend changes to new and existing contracts to best support P32H stakeholders.
• Responsible for the project management of contract implementations and renegotiation functions, from pre-contracting to activation, according to pre-determined internal guidelines and financial standards, while ensuring a smooth transition of services for members

Vendor Implementation & Management

• Assist in new vendor delegation implementation or de-delegation.
• Assist with management of Material Subcontractors.
• Vendor relationship management process including building, nurturing, and maintaining positive working relationships between P32H and its Vendors.
• Ensure contract requirements are adhered to, including language, terms, and reimbursement requirements.
• Ensure vendors obtain and maintain compliance with any P32H and or regulatory requirements.
• Act as resource for internal teams when consultant, business associate and nondisclosure agreements or other information to support Compliance are required.
• Drive continuous improvement in all aspects of the vendor oversight process.
• Other duties and projects as assigned.

Qualifications – What You Need To Perform The Job.

Education

• Required (minimum):
  Bachelor’s degree or relevant experience.
• Preferred:
  Advanced degree in business or related industry

Experience

• Required (minimum): A minimum of 5-7 years’ experience Managed Care, preferably at a Health Plan, in a network/procurement/compliance/regulatory/legal/product/operations/marketing or project management role. A minimum of 2 years’ experience managing vendor relationships at either a Health Plan or Vendor
• Preferred: 7+ years of relevant health plan experience

Skill Requirements

• Demonstrated ability to conduct negotiations. Familiarity with contract terms preferred.
• Demonstra…