Description
Location: This position is remote.Who weareFounded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.About the roleThe Clinical Vendor Program Manager manages clinical vendors to ensure strategic alignment between vendor capabilities and organizational objectives, focusing on vendor selection, contract negotiation, performance oversight, and risk management. Serves as the primary interface between clinical program/strategy and other internal and external stakeholders to maintain a multi- and inter-disciplinary vendor project coordination. The ideal candidate brings expertise in healthcare operations, vendor partnerships, and regulatory compliance to optimize the efficiency and effectiveness of vendor program offerings.What you’ll doProactively identify, evaluate, and onboard clinical vendors that align with population data insights and market demands. Assists leadership in deciding whether to add, replace, or terminate a service line to ensure current offerings support organizational and clients' needs.Develop and maintain a comprehensive multi-year roadmap including areas of exploration and implementation targets. Ensure alignment with organizational and clinical strategies, ensuring quality, cost-effectiveness, and compliance. Support contract negotiations by establishing service level agreements (SLAs) and performance guarantees (PGs) to ensure cost-effective vendor partnerships while maintaining high-quality service delivery. Develop and implement key performance indicators (KPIs) and benchmarks to assess vendor performance, drive accountability, and ensure project goals for data integration, engagement, and clinical outcomes are achieved. Proactively identify and address vendor-related challenges, ensuring seamless operations and alignment with organizational and client objectives. Monitor contract terms to ensure proper oversight.Identify opportunities to enhance vendor management processes, streamline workflows, and improve efficiency in clinical service delivery. Oversight of external and internally sourced data management to include vendor reports to ensure reporting supports clinical strategy and messaging. Significantly contribute to and support technical teams on the development of business requirements for project success. This includes defining project objectives, expected outcomes, resource requirements, and evaluation strategies to ensure vendor program effectiveness.Maintains regular communication with clinical vendors as the primary interface to review their strategic roadmaps and integration capabilities and develops joint operating committee infrastructure with vendors to regularly evaluate performance and drive vendor expectations.Partner with sales, technical, legal, procurement, and finance teams to optimize vendor strategies and integration within systems that support and align with clinical strategies. Present data and information to internal and external stakeholders by applying clinical knowledge and the use of healthcare data to drive decisions to help organizational leaders understand the clinical impact of these solutions.Partner with sales and marketing to conduct joint marketing engagement opportunities with clients and vendors. This may include marketing campaigns and vendor summits.Partner with training to drive organizational awareness of clinical vendors to drive engagement and effectiveness of vendor solutions. Ensure vendor compliance with regulatory requirements (e.g., CMS, HIPAA, NCQA, URAC as applicable) and internal policies to mitigate potential risks within the payer environment.Ensure appropriate contracts in place (e.g., BAA, NDA, and Service Agreements).Ensure vendor compliance with all contract provisions.Report to legal and risk any potential compliance or regulatory issues. Other duties as assignedWhat you’ll bringEducation: Bachelor’s Degree in health administration or a health-related field that delivers a strong clinical knowledge baseLicenses & Certifications:RN licensure preferred. Certification in Case Management (e.g., CCM), Healthcare Management (e.g., CPHQ, CHC), or Procurement (e.g., CPSM) is advantageous.Proven ability to support negotiation of contracts and manage relationships with clinical solution vendors.Strong analytical skills with the ability to interpret complex clinical data and translate it into presentations and actionable insights. Excellent problem-solving and decision-making skills.Exceptional presentation and communication skills, with experience presenting to clients.Ability to work collaboratively with cross-functional teams and external clients and consultants.Strong organizational skills and the ability to manage multiple projects simultaneously.Experience with budget forecasting and financial oversight of vendor contracts.Experience managing clinical technology solutions or care management platforms in a medical management environment.Strong understanding of medical management/clinical operations, clinical programs, and regulatory requirements.Proficiency in vendor management software and payer-related systems is a plus.Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us.#LI-HW #LI-remote
What’s in it for you
Compensation: Competitive base and incentive compensationCoverage: Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.Retirement: 401(k) plan with up to 4% employer match and full vesting on day one.
Balance: Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.Development: Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.Culture: Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.Environment: A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!
What you should know
Internal Associates: Already a Healthcare Warrior Apply internally through Jobvite.Process: Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check.Diversity, Equity and Inclusion: Quantum Health welcomes everyone. We value our diverse team and suppliers, we’re committed to empowering our ERGs, and we’re proud to be an equal opportunity employer .Tobacco-Free Campus: To further enable the health and wellbeing of our associates and community, Quantum Health maintains a tobacco-free environment. The use of all types of tobacco products is prohibited in all company facilities and on all company grounds.Compensation Ranges: Compensation details published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate’s unique combination of experience and qualifications related to the position.Sponsorship: Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.Agencies: Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.
Reasonable Accommodation: Should you require reasonable accommodation(s) to participate in the application/interview/selection process, or in order to complete the essential duties of the position upon acceptance of a job offer, click here to submit a recruitment accommodation request.
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