Reporting to the Manager of Delegated Vendors, the Delegated Vendor Specialist assists in providing delegated vendor oversight functions related to Healthfirst delegated vendors. The Delegated Vendor Specialist will support the vendor management processes and programs at Healthfirst to ensure that contractual and regulatory requirements are met.
Duties & Responsibilities:
- Monitor delegated vendor and internal business owner relationships to ensure compliance, optimal delegate performance and achievement of business goals according to Service Level Standards and other contractual requirements.
- Maintain highly effective working relationships with delegated vendors and internal business stakeholders to ensure performance metrics are met, identify opportunities for improvement, mitigate risk and eliminate barriers to correct Corrective Action Plans (CAPs).
- Serve as Liaison between vendors and cross-functional internal departments and teams to ensure timely and quality deliverables from vendors and internal departments such as Network, Claims, IT/IS, Medical Management, Credentialing and other areas as needed.
- Provide Manager with performance data on vendors based on contractual requirements and Service Level Standards on a monthly/quarterly basis.
- Participate in Vendor Oversight Committee, Joint Operating Committees and other ad hoc meetings/activities as directed by Manager.
- Analyze, track and follow-up on the timely resolution of errors and issues that are a result of vendor processes; and as necessary escalate unresolved inquiries/complaints to Manager.
- Maintain and update an Issue Tracking Log for delegated vendors.
- Assist Manager with SDOH, CMS and other internal/external audit requests as needed.
- Assist in implementation strategies to increase delegated vendor engagement strategies for HEDIS and STARS Quality Initiatives.
- Analyze, update, and modify procedures and processes to continually improve operations.
Monitor and report instances of vendor Corrective Action Plans (CAPs) implement CAPs as necessary.
- Assist Manager in other vendor delegate oversight functions as needed.
- Support manager in coordinating audit documents etc as it relates to compliance with state and federal requirements.
- Perform any other duties as may be assigned.
- Demonstrated strong organizational, analytical and interpersonal skills with detail-oriented focus.
- Demonstrated computer proficiency, including but not limited to, Microsoft Outlook and Microsoft Office Word and Excel
- MS Excel proficiency with the ability to create formulas, v-lookups, pivot tables and analyze data
- Demonstrated ability at Planning, Organizing and Executing
- Demonstrated professionalism and leadership skills along with ability to develop and direct projects
- HS Diploma or GED from an accredited program
- Knowledge of health insurance/health care/managed care environment preferred.
- Experience with MS Project, Visio and Adobe Professional
- Time Management, Critical/Creative Thinking and Problem-Solving skills.
- Should be adaptable, flexible while working in a fast-paced environment
- Experience with Relationship/Account Management
- Utilizing effective verbal and written communication skills are essential
- Bachelor's Degree or higher from an accredited institution
Compliance & Regulatory Responsibilities: NA
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement
All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
- Greater New York City Area (NY, NJ, CT residents): $65,600 - $94,775
- All Other Locations (within approved locations): $58,300 - $86,700
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.