Manager - Healthcare Vendor Contracts and Analytics

Vendor & Contract Management

Manage healthcare vendor contracts and oversee the bidding and renewal processes to ensure cost-effectiveness and service quality.

Oversee vendor performance related to customer service, claims processing, and administrative functions, including MagnaCare Customer Service and Claims.

Manage HRA administration and vendor relationships.

Oversee Pacific Health Coalition partnership with Aetna CVS to ensure contractual compliance and operational effectiveness.

Cost Containment & Strategy

Lead cost containment initiatives and identify opportunities to reduce healthcare costs while maintaining access and quality.

Collaborate with internal leadership to recommend operational improvements, vendor changes, and plan design strategies.

Compliance & Performance Oversight

Ensure vendors meet contractual obligations, regulatory requirements, and service level agreements (SLAs).

Monitor trends and resolve escalated vendor, claims, or service issues as needed.

Leadership & Team Management

Oversee and provide leadership to the Analytics and Vendor Specialist team, ensuring performance, accountability, and professional development.

Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints.

Supervises, leads, and delegates work and coaches, mentors, develops employees.

Analyzes problems, identifies, and develops alternative solutions, projects consequences of proposed actions, and implements recommendation/solutions.

Recommends hires and promotions, directs, and evaluates employment decisions for all assigned positions.

Affords assistance in developing and coordinating policies and procedures.

Responsible for the oversight of continued employee training requirements, safety, and quality initiatives.

Exemplifies the Fund’s BETTER Values and professional effectiveness dimensions in leading and fostering a respectful, trusting, and engaged culture of diversity and inclusion.

Performs other duties as assigned within the scope of responsibilities and requirements of the job.

Performs Essential Job Functions and Duties with or without reasonable accommodation.

Analytics, Reporting & Presentations

Direct the development and analysis of reports related to utilization, cost containment, vendor performance and plan outcomes.

Ensure timely and accurate reporting and prepare presentations for leadership, committees, and stakeholders.

Use data insights to support strategic planning, vendor decisions and plan design enhancements.