Payment Integrity Client & Vendor Management Manager

For roles that are 100% remote or hybrid, you 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.

Role Overview

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.

Work Arrangement

• This is a 100% Remote position but you must live in EST or CST time zones

Responsibilities

Vendor Management, Oversight, and Monitoring

• 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

Client Management

• 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

Experience and Education

• Minimum of three (3)years of experience inpriorvendor and or customer relationship management is required
• Healthcare industry or consulting background required
• Experience in reporting and analytics to monitor vendor performance
• Strong project-based acumen is preferred
• Medical Coding certification preferred
• Bachelor’s Degree preferred; Master's Degree preferred
• Experience with MS Office applications and Smartsheetpreferred

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Your career starts now. We are looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.