Vendor Manager (Health Insurance)


Immediate FTE opportunity with our client, a Federal Healthcare Insurance organization, in the BWI/Anne Arundel County Maryland area. We are seeking a Vendor Manager, with deep knowledge of the Healthcare Insurance industry (OPM and/or Federal Healthcare is a BIG PLUS) who can be responsible for all healthcare vendor interactions/selection processes for our client.

Primary Accountabilities:
- Manage performance and relationships for all vendors supporting the health plan, speciifclaly around healthcare related products and offerings
- Responsible for contracting with Utilization Management vendors in accordance with OPM and Health Plan accreditation requirements to include: Request for Proposals (RFPs), renewals, and terminations, vendor oversight audits, etc. Incorporate necessary contract changes in accordance with business needs.
- Coordinate resolution of escalated vendor-related issues from OPM, legal, and executive staff.
- Responsible for managing the Health Plans activities in all areas of Utilization Management to include: review of utilization and benefit expense (quantitative analysis of data) vendor agreements, program implementations, and related reporting systems.
- This position functions under the auspices of both Health Plan and OPM guidelines and policies.
- Design, propose, and implement utilization management programs.
- Work with internal and external sources to ensure the effectiveness of utilization management activity.
- Perform other duties as assigned.

This position is a Full Time Employment opportunity with our client, who is offering a Hybrid remote schedule for the next few months due to COVID. Our client is offering a competitive salary and benefits, which includes a PENSION! If you are interested in learning more about this exciting opportunity, then please contact Elite Technical RIGHT AWAY!!

Required Skills


- Bachelors Degree in business, actuarial science, mathematics/statistics or related field is required
- 5+ years of experience working with Healthcare vendors (day to day interactions, compliance escalations, RFP selection process, performance reviews etc-)
- Strong understanding of Health Plan Operations is required (OPM knowledge is a BIG PLUS)
- Experience with utilization management program design and administration.
- Knowledge of Healthcare Fraud, Waste, and Abuse policies/procedures
- Experience with cost containment program design to ensure the vendors are providing the best possible cost and save capital as often as possible
- Excellent oral and written communication skills.

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Location

Glen Burnie, MD

Openings

1

Anticipated Start Date

Monday, April 26, 2021

Job Type

Direct Hire

Anticipated Duration

Direct Placement

Date Posted

Thursday, April 1, 2021

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Elite Technical Services, Inc. participates in the E-Verify program to confirm the employment eligibility of all persons hired. This means that we will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's Form I-9 to confirm work authorization. Elite Technical Services, Inc. will not use E-Verify to pre-screen job applicants.

Elite Technical Services, Inc. is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.