Manager, Claims Vendor Management

Pie Insurance

10h • $110,000 - $140,000 • Remote

About The Position

The Manager, Claims Vendor Management leads Pie’s Claims Vendor Management program for assigned strategic claims vendors, with a strong focus on oversight of managed care program vendors. The role manages relationships with managed care providers, legal vendors, investigative services, claims support vendors, and API-integrated technology vendors. In partnership with Claims leadership, the Manager executes vendor strategy, supports efforts to eliminate redundant contracts, runs formal RFP processes, and leads contract negotiations and renegotiations to improve value and performance. The position requires relationship management, analytical skills to identify cost-reduction opportunities, and cross-functional collaboration to improve vendor performance and ensure billing compliance.

The Manager supports the implementation and ongoing development of the vendor management program, including centralized contract records, performance frameworks, and accountability structures. The role oversees managed care vendor quality and contractual compliance, evaluates vendor effects on medical loss costs and claim outcomes, and manages day-to-day relationships across other assigned vendor categories.

The position also facilitates vendor performance reviews, establishes KPIs, reviews vendor spend and billing practices, conducts billing audits, and supports improved billing processes. The Manager partners with Claims, Legal, Finance, Procurement, Claims Operations, Regulatory Compliance, and Claims Adjudication on vendor strategy, cost containment, contracts, compliance, product launches, and operational needs. This role is remote for team members living and working in the United States, excluding territories, with reliable high-speed internet access.

Requirements

• Bachelor’s degree in Business Administration, Finance, Supply Chain Management, or a related field.
• 6+ years of experience in vendor management, procurement, or strategic sourcing.
• 3+ years of experience in the insurance industry, preferably in claims operations or vendor management.
• 1+ years of experience leading or mentoring team members.
• Track record of leading vendor contract negotiations and achieving cost savings.
• Experience supporting or implementing vendor management programs.
• Strong understanding of the workers’ compensation and managed care vendor landscape, as well as legal, investigative, and support vendor categories.
• Working knowledge of managed care services, including medical bill review, pharmacy benefit management, utilization review, and provider networks.
• Knowledge of legal vendor management, including law firm relationships and litigation support services.
• Understanding of investigative services, transportation, translation, and other ancillary claims support vendors.
• Exposure to API-integrated technology vendors and understanding of system integration requirements.

Nice To Haves

• Direct people management experience.
• Experience with commercial auto vendors.

Responsibilities

• Support implementation of Pie’s Claims Vendor Management program for assigned strategic claims vendors.
• Execute Claims vendor management strategy in partnership with Claims leadership.
• Support and help develop vendor management team members contributing to strategic initiatives.
• Create and maintain a centralized repository of vendor contracts with visibility across departments.
• Implement vendor performance management frameworks and accountability structures.
• Support policies, procedures, work plans, and department-wide initiatives.
• Oversee managed care vendors, including medical bill review, pharmacy benefit management, utilization review, and provider networks.
• Monitor managed care vendors’ service quality, contractual obligations, and service level agreements.
• Collaborate with the Senior Director, Managed Care Services on vendor strategy and performance.
• Assess vendor performance effects on medical loss costs and claim outcomes and support portfolio optimization and cost savings.
• Manage day-to-day relationships with legal, investigative, claims support, and API-integrated technology vendors.
• Apply vendor management strategies suited to each vendor category and maintain consistent standards across assigned categories.
• Support efforts to identify and eliminate redundant or underperforming vendor contracts.
• Run formal RFP processes for competitive and transparent vendor selection.
• Lead contract negotiations, renewals, and renegotiations to improve costs and terms.
• Support sourcing strategies and analyze vendor costs against market conditions to reduce claim costs.
• Facilitate quarterly or annual meetings with Claims and vendor stakeholders to review performance and action items.
• Collect vendor performance feedback and review vendor spend and billing practices.
• Establish KPIs to monitor vendor performance and promote accountability and continuous improvement.
• Perform vendor billing audits and support spend reviews to identify incorrect billing practices.
• Serve as a point of contact for assigned strategic claims vendors.
• Support transitions to improved billing and bulk billing practices and implement agreed billing-process improvements.
• Ensure compliance with billing practices and enterprise standards.
• Apply project management skills to vendor initiatives and provide regular updates.
• Collaborate with cross-functional teams on product launches, operational needs, and strategic goals.
• Partner with Claims Operations, Regulatory Compliance, Claims Adjudication, Finance, Legal, and Procurement on vendor-related matters, budgets, cost containment, contract reviews, negotiations, and compliance.

Benefits

• Competitive cash compensation
• Comprehensive health plans
• Generous PTO
• Future-focused 401(k) match
• Generous parental and caregiver leave
• Eligible team members may receive discretionary bonuses based on annual company performance

What This Job Offers

• Job Type: Full-time
• Career Level: Manager