Network and Vendor Operations Manager

Overview

Our client presents an exciting opportunity for a mission-driven individual to play an integral role in establishing the oversight and management of vendor and provider network partnerships for our clients integrated care delivery startup. This individual will report to the Senior Director of Health Plan Operations and will be responsible for building, scaling, and continuously improving our vendor management and provider network functions, in addition to other important activities. The role will lead the continued development and improvement of the vendor procurement process, contract management life cycle and provider network administration, and will support Operations, Information Technology and other key departments in KPI development and tracking for vendors. This individual will also maintain a highly organized contract repository and network management system. Key Responsibilities ● Manage and provide third party oversight including attestation tracking, vendor governance, auditing oversight, risk management, credentialing and ensuring necessary vendor trainings are up to date ● Identify opportunities to build positive business relationships with potential providers by connecting within the community along with other leaders ● Develop contractual relationships with service providers, drafts contract agreements, and maintains provider network listings ● Partnership with Quality and Compliance team on the establishment of mock audits in preparation for future State and CMS audit readiness ● Support provider network administration, including managing our catalog of contracts, properly loading all contracts into required systems/vendors, and delivering new vendor/provider onboarding ● Support Operations, IT, Finance and other key departments with procurement, vendor management and tracking of various contract types ● Co-lead regular reviews with the Quality & Compliance Director Improvement Manager/Compliance Officer to coordinate quality assessment of providers including onsite visits of providers ● Ensures that applicable websites are monitored monthly and as needed for disciplinary summaries from the Board of Medical Examiners, as well as excluded providers from Medicare and Medicaid (OIG) ● Collaborate with the central and local owners of the vendor relationship and support in ongoing monitoring of vendor performance as needed ● Implement a regular standing meeting with key contract owners at the time of renewal to evaluate performance and contract continuance ● Develop structure for contract repository system to manage that all executed agreements with quality controls in place to ensure all contracts are up to date and tracked ● Collaborate with Quality and Health Plan Compliance teams as needed for any related Fraud, Waste & Abuse (FWA) tracking of vendors/providers ● Manage and provide oversight to selected other external vendors related to any of the functions listed above and more, ensuring quality and adherence to protocols ● Develop policies and procedures that meet applicable PACE program requirements ● Stay current on regulations and policies impacting the PACE program, health plan operations, and our compliance program and share that knowledge across the organization ● Assist the company in ad hoc special projects, including collaborations with external partners, vendor contracting, and other operating model decisions ● Continuously seek improvements to processes and systems across functions as the size and complexity of our business grows ● Communicate confidently and persuasively to all audiences, including external stakeholders Schedule and Shift Details ● M-F, 8a-5p. Based in Los Angeles in a hybrid capacity (remote AND on-site) with ability to travel (mainly locally) up to 50% based on business need. Anticipated onsite role up to 10 days per month. Travel ● Ability to travel (mainly locally) up to 50% based on business need Benefits: 401k with Employer match Your choice of 6 medical plans, with premium coverage of up to 80% for employees and 75% for all dependents Dental, vision, health savings account, flexible spending accounts, short- and long-term disability coverages PTO starting at 20 days per year; plus 12 paid holidays per year, and 2 floating holidays per year Generous CME/CEU budget and time off, and professional development opportunities One-time stipend towards setting up your home office (for remote or hybrid roles) Family friendly policies, including paid new parent leave!

Qualifications

• Bachelor's degree or higher
• Have you applied or worked for myPlace Health in the last 12 months?
• Have you spoken with your relode recruiter by phone or video regarding this role?
• 5+ years of experience in ALL of the following:
  • Understanding of health plans, healthcare provider & vendor contracting and regulatory requirements
  • Prior experience building from the ground up or scaling a provider network or contract management
  • Experience in corporate health plans, private equity and start-ups in clinical settings

• Do you have any experience working for a PACE (Program of All-Inclusive Care for the Elderly) model?

Benefits

Company

Our client was founded in 2021 by mission-aligned healthcare leaders and organizations that are committed to drastically improving health outcomes, quality and experience for vulnerable older adults and frail seniors. We are a multidisciplinary team of clinicians, operators, technologists, entrepreneurs, and builders who are united around our mission and seek meaningful careers that improve the lives of some of the most vulnerable members of our community.