Senior Vendor Compliance Program Manager

Mass General Brigham•Somerville, MA

1d•$99,466 - $144,643•Hybrid

About The Position

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. In collaboration with the Senior Director, Government programs, manage the vendor oversight programs for government payer programs (Medicare Advantage, Part D, Dual Special Needs Programs) and then state insurance programs. Set up the vendor oversight models, intake monitoring performance reports and evaluate compliance and initiate corrective action and/or process improvement activities. Collaborate with the business to set up oversight model that ensures all services delegates are managed in a compliant and timely way.

Requirements

Bachelor's Degree Related Field of Study required
At least 8-10 years of program management experience required
At least 1-2 years of team leadership experience required
Strong oral and written communication skills.
Ability to deliver presentations to a wide variety of audiences.
Ability to effectively plan and facilitate meetings and workgroups.
Excellent organizational skills and attention to detail, ability to work independently, manage multiple tasks and projects, meet deadlines, and manage a schedule.

Nice To Haves

Master's Degree Related Field of Study preferred.
Any certification in health care compliance preferred.

Responsibilities

Managed vendor corrective action plan processes
Conduct annual compliance risk assessment of vendors and use results to help craft annual monitoring and auditing program
Perform annual outreach to vendors to validate its adherence to several federal vendor requirements
Perform monthly checks of vendor information against government exclusion lists to ensure vendors are eligible for government program participation and payment
Ensure vendors are prepared to participate in external audits with regulatory agencies