HCS Vendor Manager I or II (Healthcare)

HCS Vendor Manager (Level I or II) (HEALTHCARE)

Work from home (telecommute) within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For

Every day, Cambia’s Payment Integrity – Support Services Team is living our mission to make health care easier and lives better. The Healthcare Services Vendor Manager provides support related to program evaluation, development, ensure regulatory compliance, implementation and management. Supports the implementation of new programs and the enhancement of existing programs delivered internally, through a vendor relationship, or in a hybrid model. Build and own relationships with internal customers in Healthcare Services management, vendors, vendor management and numerous departments within the company to achieve successful implementation of new or enhancement of existing programs – all in service of making our members’ health journeys easier.

If you're a motivated and experienced Vendor Manager looking to make a difference in the healthcare industry, apply for this exciting opportunity today!

What You Bring To Cambia

Qualifications and Certifications:

• Bachelor’s degree in nursing, Health Care Administration, or related field
• 5 years’ experience with an area of focus (e.g. care management or utilization management) in healthcare insurance operations
• Managing leading complete projects/programs and working with third party service providers
• Or equivalent combination of education and experience.
• Masters preferred. Previous leadership experience preferred.
  
  

Skills And Attributes (Not Limited To)

• Ability to evaluate program effectiveness, identify issues and opportunities, and work to continuously improve programs offered. Ability to analyze financial measures associated with process improvement activities.
• Strong communication and facilitation skills, including the ability to resolve issues with diplomacy and persuasiveness, and build consensus among groups of diverse stakeholders.
• Ability to track and analyze performance data and translate data into insights for decision making.
• Knowledge of health insurance industry trends and technology.
• Experience in areas of Healthcare Services practices.
• Extensive knowledge of CMS and state regulatory requirements and demonstrated ability to manage compliant operations. NCQA and/or HEDIS accreditation experience preferred.
• Ability to coordinate cross-functionally to drive solutions and resolve issues in a timely and effective manner.
• Demonstrated experience in complex program oversight.
• Familiarity with contract language and understands and can identify contractual risk, with an ability to mitigate risk.
• Demonstrated experience in designing and implementing process and technology improvement solutions.
• Strong knowledge of data abstraction and quantitative, qualitative and analytical skills.
• Ability to organize, plan, prioritize and execute several deliverables, simultaneously, within time constraints.
• Demonstrated ability to think strategically and oversee detailed execution of strategies in order to move concepts forward into actionable items.
• General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems.
  
  

What You Will Do At Cambia (Not Limited To)

• Effectively collaborates with internal program leaders, vendors and/or a combination of internal and external resources to resolve implementation, compliance, and program design challenges.
• In conjunction with internal operational leaders and/or vendor management, develops monitoring and control procedures.
• Manage moderate to complex vendor relationships ensuring the relentless pursuit of desired clinical outcomes, cost savings and favorable terms.
• Educates and trains the leadership, staff, and business associates regarding new program elements and implementation.
• Maintains a system for ongoing data/statistical reporting and program assessment. Responsible for the development and maintenance of vendor program documents, reports, etc.
• Collaborates with internal & external business partners on the collection, analysis, and maintenance of relevant data.
• Provides leadership and operational oversight of vendors. Manages vendor relationships in collaboration with vendor management. Leads the daily interface with vendor partners.
• Monitors results and metrics to ensure deliverables are met and compliance with department and regulatory standards.
• Utilizes Cambia processes and knowledge to ensure compliance with program design, contractual requirements, accreditation standards and accepted standards of care.
• Drives continuous improvement in all aspects of the vendor oversight process, including the evaluation of clinical and non-clinical program outcomes.
  
  

The expected target hiring range for the HCS Vendor Mgr (I) is $85k – $95k, the HCS Vendor Mgr (II) is $100k – $115k depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10% and 15% respectfully .  The current full salary range for the HCS Vendor Mgr (I) is $78k Low Range / $98k MRP / $128k High Range, HCS Vendor Mgr (II) is $94k Low Range / $118k MRP / $154k High Range.

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100 year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, You Can

• Work alongside diverse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.
  
  

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

Benefits

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.
  
  

Learn More About Our Benefits.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.