Job Description

Aspire Health Plan

Aspire Health Plan

Full Time (Exempt)

Day shift

80

ASP1818

Vendor Oversight Manager - Aspire Health Plan

Position Highlights

  • Excellent pay and generous benefits, including continuing education allowance
  • Excellent team-oriented culture
  • Excellent work environment!

Purpose of Position

The Vendor Oversight Manager is responsible for third party oversight of strategic vendor relationships for both Aspire Health Plan's Medicare Advantage and self-funded employer health benefit plans. The Vendor Oversight Manager serves as the primary liaison between vendors, delegated to perform specific plan operations, and internal business units. Activities include, tracking and trending of issues, auditing of contract provisions and project management. In addition, the Vendor Oversight Manager supports the Compliance Officer as required, to ensure compliance with regulatory oversight requirements of First Tier Entity (FTE) delegates.

Responsibilities

  • Manage vendors delegated to perform specific plan operations
  • Serve as the liaison between internal business units and third party vendors delegated to perform specific plan operations (i.e. claims adjudication, benefit configuration, call center operations, enrollment).
  • Serve as the subject matter expert on the vendor's contract terms; conduct oversight and auditing functions at specified intervals to ensure compliance with contract provisions, to include SLAs, KPIs and invoice amounts.
  • Identify and monitor trends, and develops and implements resolution plans
  • Lead vendor account meetings by phone and in person; conduct onsite visits as required.
  • Support internal business units in escalating operational issues to vendors in a timely manner; track open issues to closure and corrective actions to resolution.
  • Triage vendor questions to appropriate business units; track action items to resolution.
  • Project manage implementation of new vendor contracts and as applicable, new services under existing contracts.
  • In partnership with the Compliance Officer, project manage year-end readiness assessment of vendor's delegated functions.
  • Serve as the operational lead for the sub-committee for delegation oversight, under the direction of the Compliance Officer.
  • Develop and implement tools for monitoring and evaluating performance objectives and compliance.
  • Proactively anticipate issues and provide solutions for resolution
  • Partners and supports leadership across the health plan on assigned projects ensuring company goals and initiatives are met.
  • Perform other activities and functions as assigned.

Competencies

  • Problem Solving and Decision Making: Identifies, analyzes, organizes, and solves problems and issues in a timely, effective manner; uses data and input from others to make sound, timely decisions even in the face of uncertainty.
  • Integrity: Consistently honors commitments and takes responsibility for actions and words.
  • Flexibility: Demonstrates adaptability and openness to alternative solutions and flexibility when interacting with others, understanding their attitudes, needs, interests, and perspectives.
  • Inclusiveness: The ability to network and partner with all internal and external stakeholders including broad and diverse representation of private/public and traditional/non-traditional community organizations.

Experience/Skill Set

  • 5 years vendor management experience required
  • Healthcare experience preferred
  • 1 year management experience required
  • Proficiency with MS Office, Word, Power Point & Excel required
  • Project Management experience required
  • Strong communication skills, both written & verbal required
  • Good organizational skills required; must be able to work independently and prioritize projects and issues
  • Detailed oriented
  • Excellent problem solving skills

About Aspire

Aspire Health Plan is a locally owned Medicare Advantage HMO that provides comprehensive medical coverage to seniors and other Medicare recipients in Monterey County. We're proud to be a community-centered organization backed by Community Hospital of the Monterey Peninsula and Salinas Valley Memorial Hospital. Over 700 doctors, many other healthcare providers, and all four Monterey County hospitals are part of the Aspire Health Plan network. It's the care you need from people you know.


Aspire Health is an equal opportunity employer


Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

Apply Online