This job was posted by https://idahoworks.gov : For more information,please see: https://idahoworks.gov/jobs/2153324
HCS VENDOR MANAGER (HEALTHCARE)
Telecommute thru Onsite Options -
Must reside in ID, OR, UT or WA
WHO WE NEED
Healthcare Services Vendor Manager I provides support related to programevaluation, development, ensure regulatory compliance, implementationand management. Supports the implementation of new programs and theenhancement of existing programs delivered internally, through a vendorrelationship, or in a hybrid model. Build and own relationships withinternal customers in Healthcare Services management, vendors, vendormanagement and numerous departments within the company to achievesuccessful implementation of new or enhancement of existing programs
Preferred Key Experience:
Comfortable interpreting data in visualization tools such asTableau, Excel, SmartSheetComfortable presenting/leading meetings with large groups of peopleExcellent verbal and written communicationExcellent documentation and organization skills using SharePoint andOneNoteNormally to be proficient in the competencies listed below
Healthcare Services Vendor Manager would have:
Bachelor\'s Degree in Nursing, Health Care Administration, orrelated field5 years\' experience with an area of focus (e.g. care management orutilization management) in healthcare insurance operationsManaging leading complete projects/programs and working with thirdparty service providersOr equivalent combination of education and experience.Masters preferred. Previous leadership experience preferred.YOUR ROLE:
Effectively collaborates with internal program leaders, vendorsand/or a combination of internal and external resources to resolveimplementation, compliance, and program design challenges.In conjunction with internal operational leaders and/or vendormanagement, develops monitoring and control procedures.Manage moderate to complex vendor relationships ensuring therelentless pursuit of desired clinical outcomes, cost savings andfavorable terms.Educates and trains the leadership, staff, and business associatesregarding new program elements and implementation.Maintains a system for ongoing data/statistical reporting andprogram assessment. Responsible for the development and maintenanceof vendor program documents, reports, etc.Collaborates with internal & external business partners on thecollection, analysis, and maintenance of relevant data.Provides leadership and operational oversight of vendors. Managesvendor relationships in collaboration with vendor management. Leadsthe daily interface with vendor partners.Monitors results and metrics to ensure deliverables are met andcompliance with department and regulatory standards.Utilizes Cambia processes and knowledge to ensure compliance withprogram design, contractual requirements, accreditation standardsand accepted standards of care.Drives continuous improvement in all aspects of the vendor oversightprocess, including the evaluation of clinical and non-clinicalprogram outcomes.WHAT YOU BRING:
Ability to evaluate program effectiveness, identify issues andopportunities, and work to continuously improve programs offered.Ability to analyze financial measures associated with processimprovement activities.Strong communication and facilitation skills, including the abilityto resolve issues with diplomacy and persuasiveness, and buildconsensus among groups of diverse stakeholders.Ability to track and analyze performance data and translate datainto insights for decision making.Knowledge of health insurance industry trends and technology.Experience in areas of Healthcare Services practices.Extensive knowledge of CMS and state regulatory requirements anddemonstrated ability to manage compliant operations. NCQA and/orHEDIS accreditation experience preferred.Ability to coordinate cross-functionally to drive solutions andresolve issues in a timely and effective manner.Demonstrated experience in complex program oversight.Familiarity with contract language and understands and can identifycontractual risk, with an ability to mitigate risk.Demonstrated experience in designing and implementing process andtechnology improvement solutions.Strong knowledge of data abstraction and quantitative, qualitativeand analytical skills.The expected target hiring range for the HCS Vendor Mgr (I) is \$81k -\$95k, the HCS Vendor Mgr (II) is \$97k - \$114.5k depending onskills, experien