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Senior Director, Vendor Management, Network - MCC

Remote, MD, USA | Leading Healthcare - Hospitals Company

  • Industry:
    Healthcare - Hospitals
  • Position Type:
  • Functions:
    Business Development
    General Management
  • Experience:
    10-12 years
Job Description:
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Develops and leads a risk-based vendor, delegate, and subcontractor management program, exercising effective vendor management governance and operations for Magellan’s health plans. , consistent with Magellan’s mission, values, policies and procedures. Leads the monitoring and oversight of vendors’ compliance with relevant federal and state laws/regulations, contractual performance guarantees/standards, and accrediting body guidelines. Partners and leads the cross-functionally to assess, design and develop business solutions to effectively direct monitoring and oversight of vendor performance.

Works closely with internal business owners, including shared services and health plan leaders, to manage, monitor, and administer the relationships for vendors to ensure optimal performance of health plan obligations, including services to its members. Leads the pre- delegation audits, and implementation activities, as well as the development and implementation of comprehensive and consistent oversight activities to include measuring, monitoring and reporting performance levels, completing vendor scorecards, conducting vendor business review meetings, audits as required, escalating and resolving performance and services issues, and performing ongoing risk monitoring. Ensures proper contract termination and transition of vendors determined through cross- functional leadership decision-making.

Assures effective development and maintenance of relevant policies, processes, and procedures, as well as ongoing internal/external reporting in support of the health plan Vendor Management Program.

Reporting to and consistently interacting with national health plan senior leadership team, exercises a significant degree of high-touch relationship management, appreciation for highly-regulated businesses and commitments, attentive focus on execution and result-orientation, and effective leadership accountability.

Essential Functions

• Leads the operation of the overall risk-based Vendor Management program for Health Plans and other business.

• Executes an effective vendor management governance and oversight framework in consultation with associated Leading Healthcare - Hospitals Company plans and shared services stakeholders.

• Provides senior leadership-level oversight and guidance across all vendor management risk areas between vendors and business owners.

• Develops and contributes to continuous improvement in vendor governance.

• Assures clear accountability for data maintenance and audits, validation and reporting, determining contracts/third parties in scope for oversight and monitoring, vendor and contract level oversight ownership assignments, and vendor terminations.

• Participates in assessing risk associated with services being subcontracted and vendors being considered.

• Serves as thought leader in cross-functional work to establish appropriate Service-Level Agreements (SLAs) and benchmarks/ metrics for vendor relationships.

• Oversees vendors including monitoring adherence to applicable contractual, compliance and quality requirements

• Develops and utilizes vendor dashboards and scorecards to track, measure and evaluate performance.

• Proactively plans, problem solves and completes root cause analysis, and continuous monitoring of processes including Key Performance Indicators, internal dashboard reports and other business management tools to be able to monitor overall performance.

• Develops, approves and oversees mitigation and corrective action plans (including clear identification of root cause(s) to address risk and service issues as identified and assures remediation.

• Directs performance of site visits and monitoring audits as required as well as plans and leads formal periodic vendor performance reviews with stakeholders.

• Provides an escalation point to resolve vendor performance issues and communicates unresolved issues or compliance risks to executive management for discussion and action planning.

• Supports, in consultation with business owners and other key stakeholders, the development and maintenance of continuity plans to mitigate the risk of any significant interruptions to vendor services.

• Maintains communication plans to inform health plans and shared services areas of contractual services to ensure maximum value and alignment can be achieved.

• Stays abreast of changes to contracted services and partners with business owners to ensure contractual obligations are met and oversight activities are being performed, while ensuring that vendors are aware of performance expectations and

metrics.

• Maintains strategic, management-level knowledge of Leading Healthcare - Hospitals Company plan business needs and regulatory/ contractual obligations.

• Establishes policies, processes, and procedures for the risk-based Vendor Management Program, as well as governance, oversight, and monitoring activities within this program.

• Consistently monitors effectiveness of current vendor management processes and creates/executes on process improvements to ensure that activities and initiatives are completed effectively and efficiently.

• Participates in RFP and other business development opportunities and supports due diligence and evaluation process for new potential vendors as needed.

• Leads and directs employees with responsibilities in Vendor Management Program (in direct and/or matrixed reporting relationships).

Minimum Requirements:

• Bachelor's degree in business, healthcare or related field required.

• 10+ years of relevant experience in the healthcare or related industry in a vendor management, contracting, and/or monitoring/oversight role.

• Strong relationship building and leadership experience.

• Excellent time management, communication, priority management, and operational execution skills.

• Strong project management discipline and knowledge of project management tools/processes.

• Experience in highly-regulated industries, preferably health insurance or health benefits, including Medicaid/Medicare managed care.

• Highly-engaged approach toward business management with flexibility and willingness to be an agent of positive change in a dynamic business environment.

• Ability to work with and manage multiple stakeholders and competing priorities. Some travel involved.

General Job Information

Title

Senior Director, Vendor Management, Network - MCC

Grade

30

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

5/21/2019

Date Requisition Created

5/21/2019

Minimum Qualifications

Education

Bachelors: Business Administration (Required), Masters: Supply Chain Management

License and Certifications - Required

License and Certifications - Preferred

CPM - Certified Purchasing Manager - Enterprise, CPSD - Certified Professional in Supplier Diversity - Enterprise, CPSM - Certified Professional in Supply Chain Management - Enterprise, PMP - Project Management Professional - Enterprise

Other Job Requirements

Responsibilities

Healthcare industry knowledge, vendor performance and relationship management in an outsourced environment preferred.

10+ years of relevant experience in the healthcare or related industry in a vendor management, contracting, credentialing and monitoring role.

Strong relationship building and management experience.

Excellent time management, organizational and prioritization skills.

Strong project management skills and knowledge of project management tools/processes.

Experience in health insurance or health benefits including Medicare D and pharmacy benefit management.

Positive approach toward business management with flexibility and willingness to try new tasks/assignments.

Ability to manage multiple stakeholders and competing priorities.


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