Director, Vendor Performance Management

Title: Director Vendor Performance Management

Job Type: Full-time

Location: Hybrid 4 days per week in Brighton MA office; 1 day remote

FLSA Status: Exempt

About Us

BrightonOne is a nonprofit social enterprise delivering healthcare housing and hope to veterans and military-connected families with enterprise discipline in service to those who served.

Position Overview

The Director Vendor Performance Management leads USFHPs oversight of third-party vendors and delegated functions with particular focus on claims and other core operational vendors. The Director owns the vendor governance framework end to end delegation oversight SLA and performance management audits and remediation ensuring vendors meet contractual regulatory (TRICARE/USFHP DHA) and quality obligations. The Director partners across operations compliance finance and clinical teams and reports vendor performance and risk to leadership and governance committees.

Key Responsibilities

Vendor Governance & Delegation Oversight

• Own the vendor management framework including due diligence onboarding delegation agreements and pre-delegation and annual delegation audits.
• Maintain delegation oversight consistent with contractual and accreditation (NCQA/URAC) requirements including reporting and evidence.
• Manage the vendor inventory risk tiering and oversight calendar.

SLA & Performance Management

• Establish and manage SLAs performance standards and scorecards across claims and operational vendors.
• Conduct regular business reviews; monitor performance identify gaps and drive data-based accountability.
• Lead root-cause analysis corrective action plans (CAPs) and remediation for underperformance with escalation and where needed penalty/exit provisions.

Claims & Operational Vendor Oversight

• Oversee claims vendor performance including accuracy timeliness financial performance and compliance.
• Partner with technical SMEs on claims configuration testing and issue resolution.

Compliance & Reporting

• Ensure vendor oversight meets TRICARE/USFHP DHA HIPAA and accreditation requirements.
• Report vendor performance risk and remediation status to leadership and governance committees.

Leadership & Team Management

• Lead coach and develop the vendor performance management team; partner with Human Resources on hiring and development.
• Partner with operations compliance finance and clinical teams on vendor strategy and contracting.

Qualifications
Education & Experience

• Bachelors degree required; Masters degree preferred.
• 10 or more years of vendor management delegation oversight claims operations or health plan operations experience including leadership.
• Experience with claims and delegated-vendor oversight in managed care; government-program experience preferred.

Skills & Competencies

• Deep expertise in vendor/delegation oversight SLA and contract management and claims operations.
• Strong analytical negotiation and performance-management capabilities.
• Leadership cross-functional collaboration and vendor-relationship management skills.
• Excellent communication and collaboration with technical subject-matter experts and vendors.
• Proficiency in Microsoft Office Suite and platforms such as Facets QNXT HealthRules or similar systems.
• Familiarity with CMS URAC NCQA TRICARE and healthcare regulatory requirements.
• Familiarity with CAQH NPPES PECOS and provider credentialing databases.
• Experience with Medicare TRICARE managed care or government-sponsored health programs preferred.

Other Requirements

• Must be able to obtain and maintain U.S. Government personnel security clearance as a condition of employment.

Physical Nature of the Job

Some elements of the job are sedentary but the employee will be required to stand for periods of time or move throughout the campus.

Equal Opportunity Employer Statement

BrightonOne is an Equal Opportunity Employer. We prohibit discrimination and harassment of any kind based on race color religion sex (including pregnancy gender identity and sexual orientation) national origin age disability genetic information protected veteran status or any other characteristic protected by federal state or local law. We strongly encourage applications from veterans and individuals with disabilities. Accommodations are available upon request for candidates taking part in all aspects of the selection process.

Work Authorization

Candidates must be authorized to work in the United States without sponsorship now or in the future.