Centene Corporation

Vendor Performance Manager

Centene Corporation

full-time

Posted on:

Origin:  • 🇺🇸 United States • Florida, Ohio

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Salary

💰 $68,700 - $123,700 per year

Job Level

Mid-LevelSenior

About the role

  • Manages third party program relationships with Delegation partners for performance management standards, financial responsibility, and proactively implements appropriate business solutions as required
  • Acts as the critical link between our Delegation partners and internal Departments
  • Manages the facilitation from initial launch of services through day-to-day interactions
  • 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

Requirements

  • 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
  • This position is 100% remote within the United States with preference to candidates within the Central or Eastern Time Zone