Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

The Provider Vendor Manager supports sourcing, contract execution, and performance management for key vendor partners, including but not limited to Dental, Vision, Durable Medical, Transportation, Hearing, and other Medicare supplemental benefits. The Manager of Vendor Oversight is responsible for relationship management with assigned ancillary providers/vendors, as well as the contractual performance and maintenance of the vendor to ensure compliance, performance, and accurate payment. Builds relationships with internal vendor business owners across all lines of business.

Job Description

Strategy & Product Development

Contractual performance and oversight. Work with internal business partners in the management of vendor Service Level Agreements and Performance Guarantees. This includes receiving vendor reports, arranging and attending Joint Operating meetings, reviewing, and documenting vendor performance and assessing corrective actions where applicable.
Collaborate with internal and external business partners on the collection, analysis, and maintenance of relevant data.

Strategy and development - Support the development of plans and operational solutions to address changes to vendor programs on an annual basis.

Vendor Contracting

Work with finance and internal business owners to analyze ROI of various vendors.
In partnership with Product Leaders, evaluate, negotiate, and recommend changes to new and existing contracts to best support P32H stakeholders.
Responsible for the project management of contract implementations and renegotiation functions, from pre-contracting to activation, according to pre-determined internal guidelines and financial standards, while ensuring a smooth transition of services for members

Vendor Implementation & Management

Assist in new vendor delegation implementation or de-delegation.
Assist with management of Material Subcontractors.
Vendor relationship management process including building, nurturing, and maintaining positive working relationships between P32H and its Vendors.
Ensure contract requirements are adhered to, including language, terms, and reimbursement requirements.
Ensure vendors obtain and maintain compliance with any P32H and or regulatory requirements.
Act as resource for internal teams when consultant, business associate and nondisclosure agreements or other information to support Compliance are required.
Drive continuous improvement in all aspects of the vendor oversight process.

Other duties and projects as assigned.

Qualifications – what you need to perform the job.

Certification and Licensure

Education

Required (minimum): Bachelor’s degree or relevant experience.

Preferred: Advanced degree in business or related industry

Experience

Required (minimum): A minimum of 5-7 years’ experience Managed Care, preferably at a Health Plan, in a network/procurement/compliance/regulatory/legal/product/operations/marketing or project management role. A minimum of 2 years’ experience managing vendor relationships at either a Health Plan or Vendor

Preferred: 7+ years of relevant health plan experience

Skill Requirements

Demonstrated ability to conduct negotiations. Familiarity with contract terms preferred.
Demonstrated experience with value-based vendor arrangements.
Detail oriented, excellent proof reading and editing skills.

Demonstrated ability in managing work plans & holding stakeholders accountable.
Excellent analytical skills as demonstrated by significant ability to pull data, analyze complex data sets, and present in consumable reports/presentations to management.
Ability to thrive in a matrix-management, hands-on environment that demands a consultative approach and solutions that span multiple environments in a business area.
Motivated and flexible, a proponent/champion of change, able to conceptualize and envision the impact of change, and propose new ways to do business, and able to work independently and prioritize work, operating under tight deadlines.
Strong interpersonal, presentation and communication skills.
Requires the ability to maintain effective and productive peer relationships. Must have the ability to motivate fellow employees by fostering team spirit, an attitude of cooperation, and a commitment to the organization. Requires well-developed interpersonal skills to act in the capacity of liaison to the user community.

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

Must be able to work under normal office conditions and work from home as required.
Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
May be required to work additional hours beyond standard work schedule.
Anything specific to physical needs (lifting etc.)

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

Medical, dental and vision coverage
Retirement plans
Paid time off
Employer-paid life and disability insurance with additional buy-up coverage options
Tuition program
Well-being benefits
Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

We welcome all
All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org