Centene Corporation · 8 hours ago
Vendor Performance Manager
United States
Full-time
Remote
Mid, Senior Level
$70K/yr - $126K/yr
5+ years expCentene Corporation is transforming the health of communities one person at a time. The Vendor Performance Manager will manage third-party program relationships, ensuring effective communication and compliance with contracts while tracking and analyzing vendor performance to implement appropriate business solutions.
Hospital & Health Care
Responsibilities
Serve as a key account manager for assigned vendors, ensuring effective communication, compliance with contracts, and optimal performance
Manage vendor utilization including work flows for coordinating services with the Health Plan and/or Operations Departments
Provide and share monthly SLA performance dashboards and/or reporting with Delegated entity and address issues in performance of assigned SLA’s
Request and/or assist in the development of correction action plans for standards that are not met by the vendor and implement correction action plans when necessary
Track, analyze, and report on vendor performance and opportunities for improvement
Create and manage vendor scorecard and associated ratings/correction plans
Coordinate with Medical Management, Member Services, and Provider Services to educate and communicate expectations, performance and procedures to vendors
Schedule and conduct monthly meetings with Delegated entities and document discussions, issues, attendees, and action items
Research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution
Work closely with internal stakeholders to ensure vendors meet business needs and objectives
Receive and respond to provider related database information requests and concerns
Ensure operation integrity, including compliance with all policies and procedures for including adherence to state contract and guidelines
Contribute to special projects and other planning initiatives that involve oversight of the Delegated Care Management entities
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
Bachelor's Degree Business Administration, Public Administration or related field or equivalent experience required
5+ years supporting working with Primary Care Providers, Account Management experience working in Healthcare or related field, able to present to executive-level teams at the delegated entities required
Preferred
Experience working in call center customer service settings and who understands how a call center operates, how to look at reporting, verify performance, and coach performance
Experience in Medicare, specifically supporting Medicare members
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Company
Centene Corporation
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Beth Johnson
President and CEO, Coordinated Care
Clyde White
President & CEO (New Hampshire Healthy Families)
Recent News
Business Journals
2024-05-06
FierceHealthcare
2024-04-28
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