UM RN Vendor Relations Manager - Hybrid Remote

Fallon Health•Worcester, MA

8d•$115,000 - $120,000•Hybrid

About The Position

The clinical delegation vendor relations manager is responsible for handling multiple delegated UM healthcare vendor relationships as the main point of contact, managing the day-to-day operational work, delegation oversight, associated projects and instituting and monitoring operational metrics. This position will collaborate with various internal departments and program/product stakeholders at all levels to support the governance of the vendor contract relationships. This will include but not be limited to evaluating and prioritizing multiple requests put forth by internal departments/stakeholders, cadence of joint operating meetings, potential change in scope of vendor contracts and problem resolution and corrective action plans. Key interface between Fallon Health Regulatory Compliance and healthcare vendor and to ensure healthcare vendor is in compliance with federal and state requirements.

Requirements

Bachelor’s degree or equivalent work experience required.
RN Clinical licensure required; Prefer MA RN license
Minimum of three years’ experience in managed healthcare environment(s) or equivalent experience with related work in provider/healthcare vendor contracting, provider/healthcare vendor relations, utilization and care management, delegation oversight healthcare finance, provider reporting/profiling, and/or project management. Analytical, organizational, strategic and creative thinking skills are required. Excellent verbal, written and computer skills (Microsoft Word, Excel, Power Point) are essential to this position.

Nice To Haves

Master’s degree in Business Administration, Healthcare Administration, or Public Health preferred but not required.
Project Management experience valuable but not required.

Responsibilities

Performance Management:
Develop and institutionalize operational metrics
Research, collection, tracking and reporting of vendor metrics
Develop and maintain vendor scorecard to be reviewed with vendor and internal departments and stakeholders
Conduct vendor delegation audits and meetings to review vendor performance linked to regulatory compliance and contractual obligation
Main point of contact for vendor and internal departments:
Track escalated issues and reporting of root cause analysis
Troubleshoot all vendor problems and present to management as required
Identify and implement continuous enhancements and efficiencies associated with vendor management
Perform regulatory compliance and performance of Fallon’s vendors
Maintain vendor information and share with internal team related to contract obligations and day-to-day updates
Other duties: may also be assigned if needed