Provider Contracting Vendor Account Manager

Job Description:

Summary:

The position is primarily responsible for the overall relationship and management of the Provider-Vendor agreement account. This position is responsible for the building and maintaining of favorable relationships with these entities; coordinating internal resources; ensuring deliverables are meaningful timely and accurate; and issue resolution. The incumbent is also accountable for the performance of vendors within the Provider Contracting Wellness and Telemedicine teams and is responsible for vendor relationships and evaluations. The position also partners with Legal to ensure the corporation is protected by the contract and ensures all vended processes and interfaces are compliant with as State Federal and BCBS Association insurance requirements.

Essential Accountabilities:

Manages and coordinates partnerships with all contractual stakeholders and advises where applicable to include Senior Leadership Providers Vendors and key departments in the organization such as Provider Contracting Finance Product Development Marketing and Medical Services. Keeps management apprised of issues and status identifies opportunities for improvement and acts as a catalyst for change.

Responsible for supporting and maintaining vendor relationship with multiple vendors. Ensures vendors performance meets contractual and customer expectations as well as participating in governance processes for vendor performance management and those processes are following state and federal regulatory mandates.

Leads implementation of new vendor programs and changes to existing vendor programs through the development analysis and execution of all proposal responses (RFP RFR and RFI) for vendor programs. Facilitates the evaluation pricing and introduction of new products/services problem resolution and program development. Makes recommendation for selection.

Collaborates with key stakeholders to ensure proper review and approval of all contracts with external suppliers and that all contracts are signed by appropriate company officers in full compliance with delegated authorization limits. Ensures final contract documents are consistent with agreements reached at negotiations and implemented for operational governance.

Ensures all stakeholders are compliant with agreement supports cost & quality goals collaborating with stakeholders organizes & oversees committee meetings and develops recommendations for improvements in relationships & efficiency.

Develops metrics to monitor and evaluate vendor/supplier performance making recommendations for additions or removals of suppliers as appropriate. This includes creating executing and monitoring processes protocols production timeframes audits SLAs and Performance Guarantees (PGS) -having oversight of SLAs (service level agreements).

Identifies and solves contractual claims group/member and pricing issues with supplier through vendor maintenance. Supports and participates in external group and broker meetings as needed including supporting programs reviewing vendor-related concerns/issues etc. Performs quarterly claims audits to ensure accurate claims processing. Maintains monitors and reports savings in partnership with health analytics and finance against the Cost/ Benefit Analysis and ensure mitigation of any financial or other risk(s) associated with the vendor accountabilities. Reviews processes and approves all required Request For documents.

Liaises between internal teams and vendors to support the implementation of contracts and supplier relationships. Acts as project Subject Matter Expert (SME) with the business owners on projects where suppliers are responsible for delivery and turns over to operational teams. Provides recommendations including all necessary service level agreements performance guarantees and contracting verbiage.

Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies mission and values adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs.

Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

Regular and reliable attendance is expected and required.

Performs other functions as assigned by management.

Minimum Qualifications:

Minimum of five years related work experience required.

Bachelors degree in Business Administration Finance or relevant lieu of degree a minimum of six years of related work experience required.

Knowledge of the Provider and Vendor agreements/programs impact to Providers and Members. Understanding of provider contracting strongly preferred.

Knowledge in claims methodology and oversight.

Demonstrated experience in contract development/management and vendor management including monitoring and tracking vendor performance strongly preferred.

Strong organizational development skills and experience in leading multiple strategic outsourcing/vendor engagements and relationships strongly preferred.

Ability to identify contractual and supplier management risks and issues; suggest alternatives that lead to the best solution.

Demonstrated experience in integrating applications.

Strong project management skills/experience and knowledge of problem-solving tools/techniques.

Demonstrated experience with health plan claims systems and knowledge of internal processes and requirements across regions and lines of business strongly preferred.

Demonstrates experience in total RFP process to include development and analysis strongly preferred.

Experience with budget management inventory control and quality control.

Physical Requirements:

Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer.

Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

The ability to hear understand and speak clearly while using a phone with or without a headset.

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In support of the Americans with Disabilities Act this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s):

Grade E3: Minimum $60410 - Maximum $106929

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including but not limited to budget available prior experience knowledge skill and education as they relate to the positions minimum qualifications in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance retirement plan wellness program paid time away from work and paid holidays.

Please note: The opportunity for remote work may be possible for all jobs posted by the Univera Healthcare Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or status as a protected veteran.