Director of Vendor Performance
The primary objective of the position is to serve as a central point of management for organizing and facilitating cross-functional efforts to improve vendor performance and build and advance productive plan-vendor relationships. As most of Amida Care’s health plan operations are vended, it is neither feasible nor effective to assign vendor responsibilities to one person. The operational and organizational concept of this position follows the hub-and-spoke model whereby the Director is the “hub” of key vendor oversight/management activities and subject matter experts and business function leaders/staff are the “spokes.”
The functions of the “hub” role include, but are not limited to, organizing and chairing the Health Plan Operations and Vendor Performance Committee (agenda/materials/workplan/follow up activities, etc.), developing and advancing the use of operational performance metrics for vendor management, and developing and leading the completion of the projects/initiatives of a comprehensive health plan operations performance improvement and implementation work plan. The functions of the “spokes” include, but are not limited to, contributing subject matter expertise to work plan activities as directed by the Director of Vendor Performance, meaningful participation in the development of vendor performance goals (S.M.A.R.T.) and priorities in a process organized and facilitated by the Director of Vendor Performance, and participation in frequent management/oversight meetings that involve the tracking of vendor performance and key activities/deliverables.
Essential Functions are job duties and responsibilities that must be performed to accomplish the purpose/ goals of the job.
• In partnership with the EVP, VP of Information Technology, and business leadership from across the organization, lead the development, maintenance, and overall execution of a comprehensive work plan composed of the projects/initiatives necessary to drive performance improvement, achieve vendor performance goals, accomplish all new service/capability implementations (including new benefits and other set up efforts to meet new regulatory requirements);
• Design, produce, and as a key leader advance the use of performance metrics and analytical reporting as part of comprehensive vendor performance monitoring/management/oversight efforts at the health plan;
• Analyze and distribute accurate, comprehensive, and timely data and reports on vendor performance to management, officers and as needed for the Board;
• Lead – organize and facilitate the successful operations of – the Health Plan Operations and Vendor Performance Committee meeting with operational business owners from across the organization;
• Collaboratively prepare for and facilitate the successful completion of quarterly delegated vendor oversight meetings with vendor resources and operational business owners;
• Act as the liaison between vendors and cross-functional areas to ensure all operational and regulatory requirements are achieved timely;
• Problem resolution – lead the research and analysis necessary to understand and improve root cause issues as part of comprehensive and continuous performance improvement (see work plan above);
• Maintain record keeping of all Vendor Oversight Committee meetings and deliverables;
• Monitor and maintain Vendor contracts, and with executive support from EVP, VP of Information Technology, and other business areas, negotiate contracts with state-of-art practices such as service level agreements; and
• Supports all SDOH and internal audit needs in terms of vendor data and processed.
MINIMUM JOB REQUIREMENTS
• Bachelor’s Degree or an equivalent combination of education and related work experience required;
• Seven (7) to ten (10) years working with health plan operations including, but not limited to, claims, data operations, eligibility/enrollment, member service, and provider service;
• Seven (7) to ten (10) years working with vendor performance and delegated oversight and/or experience in managing large, complex projects in a health care organization, preferably within a health plan;
• Deep knowledge of managed care and Medicaid preferable;
• Demonstrated ability and experience with organizing and facilitating enterprise wide cross-functional initiatives, spanning across people, process and technology;
• Experience with work-plan development and issue/risk management;
• Experience with advancing the development and use of performance metrics;
• Personal integrity and courage to escalate issues when necessary; advocate for responsible solutions to project problems;
• Ability to work well with people from many different disciplines with varying degrees of technical experience; competence in clear, concise and tactful communication with senior management, clients, peers, and staff;
• Ability to build teams and generate a spirit of cooperation while coordinating diverse activities and groups;
• Ability to negotiate consensus amongst diverse groups and impact the activities of others not in own reporting structure;
• Ability to effectively interact with all levels of management;
• Strong verbal and written communication skills;
• Strong organizational, analytical, problem solving, and interpersonal skills;
• Strong PC Skills; Microsoft Office (Word, Excel, PowerPoint Project and Visio);
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts;
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.