NETWORK AND VENDOR OPERATIONS MANAGER - HYBRID

Job Details

• Hybrid but must be based in Los Angeles
  
• Up to 50% travel (mainly locally)
  
• Onsite up to 10 days a month
• Full Time Permanent Position
  
• Competitive Salary Bonus & Excellent Benefits
  

Responsibilities

• Manage and provide third party oversight including attestation tracking vendor governance auditing oversight risk management credentialing and ensuring necessary vendor trainings are up to date
  
• Identify opportunities to build positive business relationships with potential providers by connecting within the community along with other leaders
  
• Develop contractual relationships with service providers drafts contract agreements and maintains provider network listings
  
• Partnership with Quality and Compliance team on the establishment of mock audits in preparation for future State and CMS audit readiness
  
• Support provider network administration including managing our catalog of contracts properly loading all contracts into required systems/vendors and delivering new vendor/provider onboarding
  
• Support Operations IT Finance and other key departments with procurement vendor management and tracking of various contract types
  
• Colead regular reviews with the Quality & Compliance Director Improvement Manager/Compliance Officer to coordinate quality assessment of providers including onsite visits of providers
  
• Ensures that applicable websites are monitored monthly and as needed for disciplinary summaries from the Board of Medical Examiners as well as excluded providers from Medicare and Medicaid (OIG)
  
• Collaborate with the central and local owners of the vendor relationship and support in ongoing monitoring of vendor performance as needed
  
• Implement a regular standing meeting with key contract owners at the time of renewal to evaluate performance and contract continuance
  
• Develop structure for contract repository system to manage that all executed agreements with quality controls in place to ensure all contracts are up to date and tracked
  
• Collaborate with Quality and Health Plan Compliance teams as needed for any related Fraud Waste & Abuse (FWA) tracking of vendors/providers
  
• Manage and provide oversight to selected other external vendors related to any of the functions listed above and more ensuring quality and adherence to protocols
  
• Develop policies and procedures that meet applicable PACE program requirements
  
• Stay current on regulations and policies impacting the PACE program health plan operations and our compliance program and share that knowledge across the organization
  
• Assist the company in ad hoc special projects including collaborations with external partners vendor contracting and other operating model decisions
  
• Continuously seek improvements to processes and systems across functions as the size and complexity of our business grows
  
• Communicate confidently and persuasively to all audiences including external stakeholders
  

Requirements

• 5 years of related experience in a similar role and education concentration (e.g. certification Bachelor s or Master s) in a related field (e.g. business legal healthcare administration/MHA etc.) preferred
  
• Experience in corporate health plan venturebacked startups private equity investment banking or other financefocused roles in highgrowth and entrepreneurial environments
  
• Passion and mission orientation for serving highrisk seniors and frail older adults
  
• Strong understanding of health plan healthcare provider & vendor contracting and regulatory requirements ideally in a PACE Medicare Advantage (MAPD) or Medicare Prescription Drug Plan (PDP) organization
  
• Thrives in a relatively undefined zero to one environment unafraid to roll up your sleeves and drive a wideranging set of projects processes and deliverables
  
• Meticulous attention to detail ability to review contracts for discrepancies
  
• An independent worker who can run down problems with relatively little direction knows when and how to escalate effectively
  
• Prior experience building from the ground up or scaling a provider network or contract management function at a highgrowth healthcare organization preferred
  
• Expert proficiency in both MS Excel and PowerPoint
  
• Ability and willingness to travel 50% of the time or business need dictates
  

Benefits

• Competitive Salary
  
• PerformanceBased Cash Bonus
  
• 401k with Employer match
  
• Your choice of 6 medical plans with premium coverage of up to 80% for employees and 75% for all dependents
  
• Dental Insurance
  
• Vision Insurance
  
• Health Savings Account
  
• Flexible Spending Accounts (FSA)
  
• Short and Longterm Disability coverages
  
• PTO starting at 20 days per year; plus 12 paid holidays per year and 2 floating holidays per year
  
• Generous CME/CEU budget and time off and professional development opportunities
  
• Onetime stipend towards setting up your home office (for remote or hybrid roles)
  
• Family friendly policies including paid new parent leave!