NETWORK AND VENDOR OPERATIONS MANAGER - HYBRID
Los Angeles, CA, United States
Job Description
Job Details
Our client is seeking a Vendor and Provider Network Manager to play a key role in establishing oversight and management of vendor and provider network partnerships for their integrated care delivery startup. This individual will be responsible for building, scaling, and continuously improving vendor management and provider network functions, as well as supporting various key departments in KPI development and tracking for vendors. The ideal candidate will have a strong understanding of health plan, healthcare provider & vendor contracting and regulatory requirements, and be passionate about serving high-risk seniors and frail older adults.
Hybrid but must be based in Los Angeles
Up to 50% travel (mainly locally)
On-site up to 10 days a month
Full Time Permanent Position
Competitive Salary + Bonus & Excellent Benefits
Responsibilities
Manage and provide third party oversight including attestation tracking, vendor governance, auditing oversight, risk management, credentialing and ensuring necessary vendor trainings are up to date
Identify opportunities to build positive business relationships with potential providers by connecting within the community along with other leaders
Develop contractual relationships with service providers, drafts contract agreements, and maintains provider network listings
Partnership with Quality and Compliance team on the establishment of mock audits in preparation for future State and CMS audit readiness
Support provider network administration, including managing our catalog of contracts, properly loading all contracts into required systems/vendors, and delivering new vendor/provider onboarding
Support Operations, IT, Finance and other key departments with procurement, vendor management and tracking of various contract types
Co-lead regular reviews with the Quality & Compliance Director Improvement Manager/Compliance Officer to coordinate quality assessment of providers including onsite visits of providers
Ensures that applicable websites are monitored monthly and as needed for disciplinary summaries from the Board of Medical Examiners, as well as excluded providers from Medicare and Medicaid (OIG)
Collaborate with the central and local owners of the vendor relationship and support in ongoing monitoring of vendor performance as needed
Implement a regular standing meeting with key contract owners at the time of renewal to evaluate performance and contract continuance
Develop structure for contract repository system to manage that all executed agreements with quality controls in place to ensure all contracts are up to date and tracked
Collaborate with Quality and Health Plan Compliance teams as needed for any related Fraud, Waste & Abuse (FWA) tracking of vendors/providers
Manage and provide oversight to selected other external vendors related to any of the functions listed above and more, ensuring quality and adherence to protocols
Develop policies and procedures that meet applicable PACE program requirements
Stay current on regulations and policies impacting the PACE program, health plan operations, and our compliance program and share that knowledge across the organization
Assist the company in ad hoc special projects, including collaborations with external partners, vendor contracting, and other operating model decisions
Continuously seek improvements to processes and systems across functions as the size and complexity of our business grows
Communicate confidently and persuasively to all audiences, including external stakeholders
Requirements
5+ years of related experience in a similar role and education concentration (e.g., certification, Bachelor's, or Master's) in a related field (e.g., business, legal, healthcare administration/MHA, etc.) preferred
Experience in corporate health plan, venture-backed startups, private equity, investment banking, or other finance-focused roles in high-growth and entrepreneurial environments
Passion and mission orientation for serving high-risk seniors and frail older adults
Strong understanding of health plan, healthcare provider & vendor contracting and regulatory requirements, ideally in a PACE, Medicare Advantage (MAPD), or Medicare Prescription Drug Plan (PDP) organization
Thrives in a relatively undefined, "zero to one" environment - unafraid to "roll up your sleeves" and drive a wide-ranging set of projects, processes, and deliverables
Meticulous attention to detail - ability to review contracts for discrepancies
An independent worker who can run down problems with relatively little direction, knows when and how to escalate effectively
Prior experience building from the ground up or scaling a provider network or contract management function at a high-growth healthcare organization preferred
Expert proficiency in both MS Excel and PowerPoint
Ability and willingness to travel 50% of the time or business need dictates
Benefits
Competitive Salary
Performance-Based Cash Bonus
401k with Employer match
Your choice of 6 medical plans, with premium coverage of up to 80% for employees and 75% for all dependents
Dental Insurance
Vision Insurance
Health Savings Account
Flexible Spending Accounts (FSA)
Short- and Long-term Disability coverages
PTO starting at 20 days per year; plus 12 paid holidays per year, and 2 floating holidays per year
Generous CME/CEU budget and time off, and professional development opportunities
One-time stipend towards setting up your home office (for remote or hybrid roles)
Family friendly policies, including paid new parent leave!
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