Provider Contracting Vendor Account Manager

Provider-Vendor Agreement Account Manager

Summary : The position is primarily responsible for the overall relationship and management of the Provider-Vendor agreement account. This position is responsible for building and maintaining favorable relationships with these entities, coordinating internal resources, ensuring deliverables are meaningful, timely and accurate, and issue resolution. The incumbent is also accountable for the performance of vendors within the Provider Contracting, Wellness and Telemedicine teams and is responsible for vendor relationships and evaluations. The position also partners with Legal to ensure the corporation is protected by the contract and ensures all vended processes and interfaces are compliant with State, Federal, and BCBS Association insurance requirements.

Essential Accountabilities :

• Manages and coordinates partnerships with all contractual stakeholders and advises, where applicable, to include Senior Leadership, Providers, Vendors and key departments in the organization such as Provider Contracting, Finance, Product Development, Marketing and Medical Services. Keeps management apprised of issues and status, identifies opportunities for improvement, and acts as a catalyst for change.
• Responsible for supporting and maintaining vendor relationship with multiple vendors. Ensures vendors' performance meets contractual and customer expectations as well as participating in governance processes for vendor performance management and those processes are following state and federal regulatory mandates.
• Leads implementation of new vendor programs and changes to existing vendor programs through the development, analysis and execution of all proposal responses (RFP, RFR and RFI) for vendor programs. Facilitates the evaluation, pricing and introduction of new products / services, problem resolution, and program development. Makes recommendation for selection.
• Collaborates with key stakeholders to ensure proper review and approval of all contracts with external suppliers and that all contracts are signed by appropriate company officers, in full compliance with delegated authorization limits. Ensures final contract documents are consistent with agreements reached at negotiations and implemented for operational governance.
• Ensures all stakeholders are compliant with agreement, supports cost & quality goals collaborating with stakeholders, organizes & oversees committee meetings and develops recommendations for improvements in relationships & efficiency.
• Develops metrics to monitor and evaluate vendor / supplier performance, making recommendations for additions or removals of suppliers as appropriate. This includes creating, executing, and monitoring processes, protocols, production timeframes, audits, SLA's and Performance Guarantees (PGS) having oversight of SLA's (service level agreements).
• Identifies and solves contractual, claims, group / member and pricing issues with supplier through vendor maintenance. Supports and participates in external group and broker meetings as needed including supporting programs, reviewing vendor-related concerns / issues, etc. Performs quarterly claims audits to ensure accurate claims processing. Maintains, monitors, and reports savings in partnership with health analytics and finance against the Cost / Benefit Analysis and ensure mitigation of any financial or other risk(s) associated with the vendor accountabilities. Reviews, processes, and approves all required "Request For" documents.
• Liaises between internal teams and vendors to support the implementation of contracts and supplier relationships. Acts as project Subject Matter Expert (SME) with the business owners on projects where suppliers are responsible for delivery and turns over to operational teams. Provides recommendations including all necessary service level agreements, performance guarantees, and contracting verbiage.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Minimum Qualifications :

Physical Requirements :

Equal Opportunity Employer