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.
- 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!!
- 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.
Glen Burnie, MD
Monday, April 26, 2021
Thursday, April 1, 2021
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