Manager, Vendor Management

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Oversee all aspects of vendor operations for Utilization Management staff vendors.

• Manage vendor usage, including workflows for service coordination.

• Analyze vendor data and generate necessary reports for the health plan, Corporate, and state agencies.

• Develop and maintain vendor scorecards along with associated ratings and corrective action plans.

• Serve as a primary account manager for critical providers and vendors.

• Collaborate with cross-functional teams regarding vendor expectations, performance, and procedures.

• Educate and communicate vendor expectations, performance metrics, and procedures with Medical Management, Member Services, and Provider Services.

• Facilitate monthly meetings, documenting discussions, issues, attendees, and action items.

• Investigate and resolve claims disputes involving vendors, members, or providers, and route issues for resolution.

• Address provider-related database information requests and concerns.

• Ensure operational integrity and adherence to policies, procedures, and federal and state contracts and guidelines.

• Initiate or assist in formulating corrective action plans for unmet vendor standards.

⛳️ Requirements

• Bachelor's degree in public health, business, or a related field, or equivalent experience.

• A minimum of 4 years of experience in healthcare management.

• Experience in vendor managed care or the health insurance sector is preferred.

• Clinical vendor management experience is highly desirable.

• Leadership experience is strongly preferred.

• Experience in managed care (Medicare/Medicaid/Commercial) is highly sought after.

• Familiarity with reporting and data analysis is preferred.

• Proficient Excel skills and experience with various software data programs are preferred.

• Project management experience is a plus.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase program.

• Tuition reimbursement opportunities.

• Paid time off in addition to holidays.

• Flexible work options including remote, hybrid, field, or office schedules.

• Additional incentives may be included in total compensation.