Payment Integrity Client & Vendor Management Manager

Role Overview

The Payment Integrity Vendor/Client Management Manager assists the organization in getting the best value from Population Health and Payment Integrity vendors while minimizing risk, streamlining processes, reducing costs, increasing efficiency, and improving the quality of services provided. The position of Vendor/Client Management Manager is accountable for supporting and maintaining relationships with AmeriHealth Caritas Family of Companies (ACFC) lines of business (LOB), and vendors supporting the Population Health commitments to programmatic clinical outcomes and operational efficiencies.

Work Arrangement

This is a 100% Remote position but you must live in EST or CST time zones.

Responsibilities

• Vendor Management, Oversight, and Monitoring
  • Develop a vendor management strategy for the Population Health subset of vendors
  • Manage a set of vendor oversight criteria and metrics for vendors to achieve Population Health results for the company
  • Participate in all negotiations, including the establishment of metrics and KPIs that align with broader Population Health outcomes and measures
  • Lead or participate in vendor audits on behalf of Population Health
  • Gain knowledge in understanding oversight roles as it relates to CMS regulations for oversight
  • Collaborate with implementation teams to ensure clean handoffs into monitoring and oversight
• Client Management
  • Manage the coordination of client meetings for Population Health to include:
  • Reporting on Population Health programs by plan
  • Develop and manage a LOB Issue repository/process and coordinate closure across the Population Health organizations – communicate status monthly
  • Support the reconciliation of invoices against deliverables
  • Represent ACFC Population Health organization at all meetings with LOB Compliance Officers/Coordinators with State and Regulatory Agencies with and/or for the Director

Experience And Education

• Minimum of three (3) years of experience in prior vendor and/or customer relationship management is required
• Healthcare industry or consulting background required
• Experience in reporting and analytics to monitor vendor performance
• Strong project-based acumen is preferred
• Medical Coding certification preferred
• Bachelor’s Degree preferred; Master’s Degree preferred

Our Comprehensive Benefits Package

• Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k)
• Tuition reimbursement and more.

Benefits

• Your career starts now.
• We are looking for the next generation of healthcare leaders.
• AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience.
• We deliver comprehensive, outcomes-driven care to those who need it most.
• We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
• Discover more about us at www.amerihealthcaritas.com.