Vendor Management Lead

Humana • New York, NY

2d • Remote

About The Position

Humana is looking for a Vendor Management Lead with experience in healthcare services to work as a liaison between our vendor partners in the Northeast region and our market clinical operations teams. This is a remote work opportunity, and we are looking for cross-functional leadership, vendor relations and healthcare payor experience. The Vendor Management Lead serves as a key leader overseeing vendor partner management activities within the market. This professional will ensure strategic alignment between Humana's business objectives, clinical operations, vendor partners, and providers. Main responsibilities include the following: Provide direction and operational support to healthcare service vendor partners Collaborate with internal program teams to manage vendor activities tied to quality and risk adjustment goals. Collaborate with Provider Engagement teams to monitor and evaluate outcomes for Value Based and Delegated Services Providers, ensuring the delivery of high value, coordinated services across the region. Manage vendor deliverables, contractual obligations, and service-level agreements. Track, prioritize, and oversee a high volume of vendor activities while supporting internal Humana partners. Identify issues, communicate findings, and influence process improvements. Facilitate issue resolution, identifying and addressing process gaps, and optimizing workflows to enhance the quality of care and promote operational excellence.

Requirements

• Bachelor's degree or an equivalent combination of education and work experience
• 3 or more years of progressive healthcare experience
• 3 or more years of vendor relations experience
• 2 or more years of leadership experience
• Proficiency communicating across all organizational levels
• Experience having crucial conversations that improve performance and maintain relationships
• Experience interpreting and using data to problem solve and influence others

Nice To Haves

• Licensed Registered Nurse (RN), with no disciplinary action
• Experience in Medicare Risk Adjustment
• Certification with Six Sigma and/or the Project Management Institute
• Prior experience in an insurance setting
• Grievance and Appeals experience
• 5-10% travel within the market (Northeast)

Responsibilities

• Provide direction and operational support to healthcare service vendor partners
• Collaborate with internal program teams to manage vendor activities tied to quality and risk adjustment goals.
• Collaborate with Provider Engagement teams to monitor and evaluate outcomes for Value Based and Delegated Services Providers, ensuring the delivery of high value, coordinated services across the region.
• Manage vendor deliverables, contractual obligations, and service-level agreements.
• Track, prioritize, and oversee a high volume of vendor activities while supporting internal Humana partners.
• Identify issues, communicate findings, and influence process improvements.
• Facilitate issue resolution, identifying and addressing process gaps, and optimizing workflows to enhance the quality of care and promote operational excellence.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

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