Manager, Health & Wellness Vendor Management-RN Required (Rancho Cordova, CA) Job in Rancho Cordova 95670, California Us
JOB SUMMARY:
The RN Manager, Health Wellness Vendor Management is accountable for providing leadership and strategic support to Vendor Operations Management. This position will manage a department charged with managing the operational aspects of HN relationships with its third party vendors and risk entities. Supports the Decision Power Health and Wellness Program.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Monitors the operational aspects of the vendor relationship through execution of audits and evaluations of financial and operational performance that will ensure that contract terms, standards and expectations are met-by both the vendor and by HN. Supports contract negotiation teams with recommendations and guidance on changes to contract terms and performance measurements based on these audits.
- Develops and maintains successful relationships with our vendors and identifying key goals, deliverables and timetables for the year's initiatives.
- Supports various functional business units' efforts and interests by ensuring optimal performance of its vendors and performing analysis of potential vendor impacts.
- Monitors and reports on vendor performance to internal oversight committees and assists business owners in developing corrective action plans.
- Identifies systemic issues and develops and executes strategies to address these issues through Health Net and vendor specific initiatives. Provides recommendations to the vendors to improve performance.
- Assists in planning and direction of the vendor processes and reports to support new products, joint ventures and other business activities in which Health Net Inc is engaged, taking into consideration operational implications. Participates in cross-departmental implementation teams including the system migration or consolidation efforts.
- Ensures and monitors vendors performance standards and metric measurements with company wide, product and customer specific measures.
- Manages and is responsible for the timely identification and resolution of problems and issues that arise during the course of the day to day functioning of the vendor relationship by developing response time and prioritization standards and identifying point persons in each functional and escalation procedures.
- Ensures that vendors adhere to all applicable legal, regulatory and accreditation mandates.
- Supports and manages activities critical to maintaining compliance for CMS, DMHC, DHS, and NCQA around disease management for the Western Region.
- Provides clinical input for the development, maintenance, and revision of performance guarantees.
- Responsible for accurate and timely RFI, RFP and RFR responses.
- Supports Sales efforts and presentations to large and major accounts.
REQUIREMENTS:
Education:
Bachelors Degree in Business or Nursing required.
Certification/License:
Active, valid unrestricted state of CA Registered Nurse license required.
Experience:
- Minimum five years experience in a technical discipline associated with health care.
- Three years experience in medical management or health care services required.
- Three years Management experience in a corporate setting required.
- Must have vendor management experience.
- Operational experience with program implementation and management.
- Project management experience highly recommended.
Knowledge, Skills Abilities:
- Extensive knowledge and experience in document management technologies, systems, and related services.
- Able to manage national program and staff remotely.
- Able to effectively manage complex projects in a highly dynamic environment.
- Must have strong management, analytical and negotiation skills.
- Must have strong presentation skills.
- Knowledge of the managed care industry from both an internal and external perspective.
- Must have strong technical skills in Microsoft Office Suite. Microsoft Project, Visio and Access preferred.
- Must be an effective communicator, fast learner and be able to generate effective credibility with departments outside of their scope of control.
- Flexibility and "big picture" vision are essential.
- Must be able to travel as needed.
OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.
Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.
Additional Information:
- Travel Percentage: 25%
