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Health Net · 1 day ago

Vendor Performance Manager

United States

Full-time

Remote

Senior Level

$70K/yr - $126K/yr

5+ years exp

Centene is transforming the health of our communities, one person at a time. The Vendor Performance Manager will manage third-party program relationships with Delegation partners, ensuring compliance with contracts and optimal performance, while acting as the critical link between partners and internal departments.

Financial ServicesHealth CareHealth InsuranceInsurancePersonal HealthWellness

Responsibilities

Serve as a key account manager for assigned vendors, ensuring effective communication, compliance with contracts, and optimal performance

Manage vendor utilization including work flows for coordinating services with the Health Plan and/or Operations Departments

Provide and share monthly SLA performance dashboards and/or reporting with Delegated entity and address issues in performance of assigned SLA’s

Request and/or assist in the development of correction action plans for standards that are not met by the vendor and implement correction action plans when necessary

Track, analyze, and report on vendor performance and opportunities for improvement

Create and manage vendor scorecard and associated ratings/correction plans

Coordinate with Medical Management, Member Services, and Provider Services to educate and communicate expectations, performance and procedures to vendors

Schedule and conduct monthly meetings with Delegated entities and document discussions, issues, attendees, and action items

Research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution

Work closely with internal stakeholders to ensure vendors meet business needs and objectives

Receive and respond to provider related database information requests and concerns

Ensure operation integrity, including compliance with all policies and procedures for including adherence to state contract and guidelines

Contribute to special projects and other planning initiatives that involve oversight of the Delegated Care Management entities

Performs other duties as assigned

Complies with all policies and standards

Qualification

Vendor ManagementPerformance AnalysisHealthcare ExperienceAccount ManagementCommunication SkillsProblem SolvingTeam Collaboration

Required

Bachelor's Degree 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 required