ICONMA, LLC Senior Vendor Manager Healthcare/Managed care in Boston, Massachusetts
First point of escalation within Vendor Management Team for any complex, high profile or high cost issue needing resolution
Accountable for timely resolution of escalated issues (e.g. complaints, inquiries) raised by external parties (e.g. members, providers, MassHealth, CMS, Connector, NH DHHS, trade associations, Client Chief Executive Officer) and sharing resolution with Public Partnerships and/or CMO
Provides ongoing mentoring and training to Vendor Management staff and develops associated training materials and resource materials
Accountable for strategizing with Plan senior leadership, Chief Clinical Officer, Finance and vendors to identify ongoing cost savings opportunities
Accountable for managing RFPs and writing timely responses for vendors to RFP questions Due Diligence through Vendor Selection - Lead benchmark research to identify potential vendors based on industry research
Point person to coordinate exchange of information, documentation and data via Request for Information to facilitate vendor selection
Synthesize and present key findings and proposals of potential vendors to stakeholders
Coordinate onsite vendor presentations and evaluation of each vendor
Present summary of information and presentations to stakeholders to select vendor
Document due diligence leading to vendor selection Implementation of New Line of Business or New Vendor
Conducts pre-delegation assessment of any delegated NCQA related activities if applicable
Collaborates with Accreditation Manager to write delegation agreement and reporting exhibit for delegated NCQA related activities.
Negotiates initial contract in collaboration with legal and finance, involving key stakeholders if needed
Reviews and revises related member handbook or evidence of coverage language, manual and vendor policies and procedures.
Facilitates identification of all implementation business requirements and interdependencies
Completes documentation required by regulatory agencies (e.g. MassHealth Material Subcontractor Checklist)
Chairs or co-chairs vendor oversight committee
Manages the activities of complex work processes to achieve program goals including but not limited to ensuring that the vendor is meeting contractual, regulatory and accreditation requirements
Manages, tracks and resolves day to day issues
Renegotiates contract modifications or renewals in collaboration with legal and finance
Recommends program or contractual changes to senior management to improve vendor performance or increase cost savings
Develops corrective action plan with vendor for suboptimal performance and monitors results
Manages the Plan’s contract with the vendor and reconciles administrative billing
Monitors network adequacy, identifies potential risks and escalates appropriately if applicable
Leads development/revision of reports in collaboration with other areas of the company including but not limited to business intelligence, finance and claims, ongoing meetings with Plan staff and vendor staff.
Reviews available data and metrics to identify trends that may need to be addressed
Bachelor’s Degree or the equivalent combination of training and experience, plus 4-7 years related experience.
7+ years healthcare/managed care experience in vendor management, project/program management
As an equal opportunity employer, ICONMA prides itself on creating an employment environment that supports and encourages the abilities of all persons regardless of race, color, gender, age, sexual orientation, citizenship, or disability.