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You will be updated with latest job alerts via emailVendor Manager (Level I or II) (HEALTHCARE)
Work from home (telecommute) within Oregon Washington Idaho or Utah
Build a career with purpose. Join our Cause to create a personfocused and economically sustainable health care system.
Who We Are Looking For:
Every day Cambias Payment Integrity Support Services Team is living our mission to make health care easier and lives better. The Healthcare Services Vendor Manager provides support related to program evaluation development ensure regulatory compliance implementation and management. Supports the implementation of new programs and the enhancement of existing programs delivered internally through a vendor relationship or in a hybrid model. Build and own relationships with internal customers in Healthcare Services management vendors vendor management and numerous departments within the company to achieve successful implementation of new or enhancement of existing programs all in service of making our members health journeys easier.
If youre a motivated and experienced Vendor Manager looking to make a difference in the healthcare industry apply for this exciting opportunity today!
What You Bring to Cambia:
Preferred Key Experience:
Comfortable interpreting data in visualization tools such as Tableau Excel SmartSheet
Comfortable presenting/leading meetings with large groups of people
Excellent verbal and written communication
Excellent documentation and organization skills using SharePoint and OneNote
Qualifications and Certifications:
Bachelors degree in nursing Health Care Administration or related field
5 years experience with an area of focus (e.g. care management or utilization management) in healthcare insurance operations
Managing leading complete projects/programs and working with third party service providers
Or equivalent combination of education and experience.
Masters preferred. Previous leadership experience preferred.
Skills and Attributes (Not limited to):
Ability to evaluate program effectiveness identify issues and opportunities and work to continuously improve programs offered. Ability to analyze financial measures associated with process improvement activities.
Strong communication and facilitation skills including the ability to resolve issues with diplomacy and persuasiveness and build consensus among groups of diverse stakeholders.
Ability to track and analyze performance data and translate data into 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 and demonstrated ability to manage compliant operations. NCQA and/or HEDIS accreditation experience preferred.
Ability to coordinate crossfunctionally to drive solutions and resolve issues in a timely and effective manner.
Demonstrated experience in complex program oversight.
Familiarity with contract language and understands and can identify contractual risk with an ability to mitigate risk.
Demonstrated experience in designing and implementing process and technology improvement solutions.
Strong knowledge of data abstraction and quantitative qualitative and analytical skills.
Ability to organize plan prioritize and execute several deliverables simultaneously within time constraints.
Demonstrated ability to think strategically and oversee detailed of strategies in order to move concepts forward into actionable items.
General computer skills (including use of Microsoft Office Outlook internet search). Familiarity with health care documentation systems.
What You Will Do at Cambia (Not limited to):
Effectively collaborates with internal program leaders vendors and/or a combination of internal and external resources to resolve implementation compliance and program design challenges.
In conjunction with internal operational leaders and/or vendor management develops monitoring and control procedures.
Manage moderate to complex vendor relationships ensuring the relentless pursuit of desired clinical outcomes cost savings and favorable terms.
Educates and trains the leadership staff and business associates regarding new program elements and implementation.
Maintains a system for ongoing data/statistical reporting and program assessment. Responsible for the development and maintenance of vendor program documents reports etc.
Collaborates with internal & external business partners on the collection analysis and maintenance of relevant data.
Provides leadership and operational oversight of vendors. Manages vendor relationships in collaboration with vendor management. Leads the daily interface with vendor partners.
Monitors results and metrics to ensure deliverables are met and compliance with department and regulatory standards.
Utilizes Cambia processes and knowledge to ensure compliance with program design contractual requirements accreditation standards and accepted standards of care.
Drives continuous improvement in all aspects of the vendor oversight process including the evaluation of clinical and nonclinical program outcomes.
The expected target hiring range for the Vendor Mgr (I) is $85k $95k the Vendor Mgr (II) is $100k $115k depending on skills experience education and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10 and 15 respectfully. The current full salary range for the HCS Vendor Mgr (I) is $78k Low Range / $98k MRP / $128k High Range HCS Vendor Mgr (II) is $94k Low Range / $118k MRP / $154k High Range.
About Cambia
Working at Cambia means being part of a purposedriven awardwinning culture built on trust and innovation anchored in our 100 year history. Our caring and supportive colleagues are some of the best and brightest in the industry innovating together toward sustainable personfocused health care. Whether were helping members lending a hand to a colleague or volunteering in our communities our compassion empathy and team spirit always shine through.
Why Join the Cambia Team
At Cambia you can:
We believe a career at Cambia is more than just a paycheck and your compensation should be too. Our compensation package includes competitive base pay as well as a marketleading 401(k) with a significant company match bonus opportunities and more.
In exchange for helping members live healthy lives we offer benefits that empower you to do the same. Just a few highlights include:
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobaccofree workplace. All qualified applicants will receive consideration for employment without regard to race color national origin religion age sex sexual orientation gender identity disability protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability please email . Information about how Cambia Health Solutions collects uses and discloses information is available in our .
Required Experience:
Manager
Full-Time