Department: Operations National Contracting
Reports to: Sr. Manager National Contracting
Location: 8735 Henderson Road, Tampa FL 33634Monitors and maintains vendor relationships across multiple markets and products. Maintains long-term performance oversight functions that enable compliant, cost-effective, delivery of medical services. Resolves vendor issues and recommends solutions analogous to best practices. Monitors and maintains contractual vendor payment and assists in implementation activities.
- Monitors assigned delegated vendor relationships with the responsibility for ensuring contractual requirements and performance service levels of delegated functions are adhered to in a compliant manner.
- Drives compliant resolution of all vendor issues and including vendor communications and reporting.
- Tracks and resolves vendor FFS payment and other issues by working with internal departments, vendors and finance
- Conducts quarterly JOC meetings with internal partners and vendors
- Develops and maintains approved vendor document library
- Interfaces with management (corporate and market level) and WellCare matrix partners in order to ensure contractual obligations are achieved.
- Assist managers with implementation, escalations and follow up items as needed
- Maintains highly effective working relationships with vendors and internal matrix partners in order to improve vendor performance
- Develop step actions, trainings and other documents to support department processes and education
- Assist in the development and maintenance of various Corporate Ancillary policies and procedures effecting Vendor Management.
- Manage projects including implementations for delegated functions as needed
- Collaborates with functional areas to ensure vendors provide compliant day to day operations that bring quality and value to the total enterprise.
- Works with internal parties and vendors set up processes to reduce frequency of FFS issues
- Performs other duties as assigned.
- Drives ongoing process improvement to deliver increasing vendor quality, compliance, and efficiency in all vendor related processes.
- Required a Bachelor's Degree in a related field or equivalent work experience 2 additional years of vendor management or oversight preferably with healthcare vendors
- Required 2 years of experience in Handling service issues for members and providers
- Required 3 years of experience in vendor management or oversight preferably with healthcare vendors
- Required Other Demonstrated aptitude and experience for managing processes across functional teams
- Required Other Solid understanding of managed care, vendor provider agreements and the delegation process
- Preferred Other Medicare/Medicaid health plan experience
Licenses and Certifications:
- Intermediate Demonstrated interpersonal/verbal communication skills Strong interpersonal skills and verbal/written communication skills with demonstrated ability to influence internal/ external constituents
- Intermediate Demonstrated written communication skills
- Intermediate Ability to influence internal and external constituents
- Intermediate Ability to work in a fast paced environment with changing priorities Ability to work in a fast paced environment with changing priorities
- Intermediate Ability to effectively present information and respond to questions from peers and management
- Intermediate Ability to work independently Highly Motivated individual with the ability to work independently
- Intermediate Ability to communicate and make recommendations to upper management
- Intermediate Other Solid understanding of managed care, vendor provider agreements and the delegation process
- Intermediate Other Ability to handle responsibilities that are complex with results that may have long-range implications
- Intermediate Other Ability to remain calm under pressure
A license in one of the following is required:
- Required Intermediate Microsoft Word Proficient in Microsoft Office such as Word, Excel, PowerPoint and Outlook
- Required Intermediate Microsoft Excel Knowledge of or ability to learn Peradigm, Sidewinder and other company software applications
- Required Intermediate Microsoft PowerPoint
- Required Intermediate Microsoft Outlook
- Required Intermediate Healthcare Management Systems (Generic)