Payment Integrity Client & Vendor Management Manager

Amerihealth Caritas•,

6d•Remote

About The Position

The Payment Integrity Vendor/Client Management Manager assists the organization in getting the best value from Population Health and Payment Integrity vendors while minimizing risk, streamlining processes, reducing costs, increase efficiency, and improving the quality of services provided. The position of Vendor/Client Management Manager is accountable for supporting and maintaining relationships with AmeriHealth Caritas Family of Companies (ACFC) lines of business (LOB), and vendors supporting the Population Health commitments to programmatic clinical outcomes and operational efficiencies.

Requirements

Minimum of three (3)years of experience in prior vendor and or customer relationship management is required
Healthcare industry or consulting background required
Experience in reporting and analytics to monitor vendor performance
Must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required.
Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Nice To Haves

Strong project-based acumen is preferred
Medical Coding certification preferred
Bachelor’s Degree preferred; Master's Degree preferred
Experience with MS Office applications and Smartsheet preferred
Must live in EST or CST time zones

Responsibilities

Develop a vendor management strategy for the Population Health subset of vendors
Manage a set of vendor oversight criteria and metrics for vendors to achieve Population Health results for the company
Participate in all negotiations, including the establishment of metrics and KPIs that align with broader Population Health outcomes and measures
Lead or participate in vendor audits on behalf of Population Health
Gain knowledge in understanding oversight roles as it relates to CMS regulations for oversight
Collaborate with implementation teams to ensure clean handoffs into monitoring and oversight
Manage the coordination of client meetings for Population Health to include: Reporting on Population Health programs by plan
Develop and manage a LOB Issue repository/process and coordinate closure across the Population Health organizations – communicate status monthly
Support the reconciliation of invoices against deliverables
Represent ACFC Population Health organization at all meetings with LOB Compliance Officers/Coordinators with State and Regulatory Agencies with and/or for the Director