Dir, Vendor Management, Network

United States

Job Description

Provides leadership in the formation and execution of a risk based Delegate and Vendor Management program compliant with Magellan's delegation oversight policies and procedures. Will direct monitoring of delegates and vendors' compliance with relevant state laws, federal regulations, accrediting body guidelines, contractual performance guarantees and company policies. Will work cross-functionally to analyze, design and develop business solutions as it pertains to delegate and vendor management planning. Will work closely with internal business owners and health plan leaders to manage and administer the relationships for delegates and vendors to ensure optimal service to members. Will lead pre-delegation audits, and implementation activities. Will develop and implement oversight activities to include measuring, monitoring and reporting performance levels, completing vendor scorecards, conducting vendor business review meetings, audits as required, escalating and resolving customer services issues, performing ongoing risk monitoring. Will ensure proper contract termination of delegates and vendors as directed by health plan leadership.
  • Directs the implementation of the overall risk-based Delegate and Vendor Management program in new markets.
  • Executes a delegate and vendor oversight program in consultation with associated health plan stakeholders.
  • Participates in assessing risk associated with services being contracted and the delegates and vendors being considered.
  • Participates in RFPs and support the due diligence and evaluation process for new potential delegates and vendors as needed.
  • Assists in establishing appropriate SLAs and metrics for delegate and vendor relationships.
  • Informs functional departments of contractual services to ensure maximum value can be extracted from the delegate and vendor contract.
  • Responsible for managing delegates and vendors as assigned including; monitoring contractual requirements, monitors and evaluates delegates and vendors on an ongoing basis to maintain quality and compliance with accreditation and contractual requirements.
  • Develops and monitors delegate and vendor dashboards and scorecards to track, measure and evaluate performance.
  • Proactively plans, problem solves and completes root cause analysis, and continuous monitoring of processes including Key Performance Indicators, internal dashboard reports and other business management tools to be able to monitor overall performance.
  • Develops mitigation and corrective action plans to address risk and service issues as identified and follows through to resolution.
  • Performs site visits and monitoring audits as  required.  Plans and conducts formal periodic delegate and vendor performance reviews with stakeholders.
  • Provides an escalation point to resolve contractual issues.
  • Maintains knowledge on current delegate and vendor services and capabilities and industry outsourcing trends.
  • Establishes policies and procedures for the risk-based Delegate and Vendor Management program and monitoring activities.
  • Ensures enterprise needs for due diligence, risk assessment and continuing delegate and vendor monitoring are accomplished.

General Job Information

Title

Dir, Vendor Management, Network

Grade

29

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

7/25/2019

Date Requisition Created

7/25/2019

Work Experience

Healthcare

Education

Bachelors: Business Administration, Masters

License and Certifications - Required

License and Certifications - Preferred

CPM - Certified Purchasing Manager - Enterprise, CPSM - Certified Professional in Supply Chain Management - Enterprise

Other Job Requirements

Responsibilities

  • Strong relationship building and management experience.
  • Excellent communication skills, time management, organizational and prioritization skills.
  • Strong project management skills and knowledge of project management tools/processes.
  • Experience in health insurance or health benefits including Medicare D and pharmacy benefit management.
  • Positive approach toward business management with flexibility and willingness to try new tasks and assignments.
  • Ability to manage multiple stakeholders and competing priorities.
  • Will travel 15-30% of the time for delegate and vendor site audits and business meetings.
  • 7+ years of relevant experience in the healthcare or related industry in a vendor management, contracting, credentialing and monitoring role.
  • Healthcare industry knowledge, vendor performance and relationship management in an outsourced environment preferred.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.