Job Description
Job DescriptionJob Summary
This position is responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other Core Ops, Payment Integrity, IT and Government Contracts areas of responsibilities). Role is predicated on building relationships with vendors, stakeholders, functional counterparts, and Core Operations leadership and exhibiting a strong understanding of operations, stakeholder needs and satisfaction, financial budgets, and current and future program initiatives. Ability to drive operational excellence and process-oriented efficiencies is essential as well as the ability to critically think to resolve business issues in a cost-effective and out-of-the-box manner. This position oversees vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality metrics. Accountable for offering innovative guidance and solutions to address emerging business concerns and respond to growth initiatives in order to appropriately scale vendor relationships to meet business demands. Responsibilities include oversight of the onboarding of vendor resources, managing performance, monitoring, and mitigating risks to ensure service delivery by vendors is in accordance with the Service Level Agreements between the parties.
Job Duties
Accountable for over-arching key vendor relationships and serves as liaison between stakeholders, functional counterparts, vendors, and Core Operations leadership
Aligns to Core Operations’ strategic direction and priorities toward a common vision; clarifies roles and responsibilities for staff; promotes empowerment
Staffs, organizes, monitors and maintains an effective, consistent Vendor Management function
Supervise Molina Healthcare vendor management staff
Ensures departmental and individual performance goals are met
Oversees multiple initiatives of varying size (scale), complexity, and duration involving staff and matrixed resources
Translates strategy into tactical business activities, acting as a change agent
Serves as focal point of escalation for vendor issues and disputes, and drives issues to resolution
Makes needed decisions to ensure the successful resolution of all issues, problems and changes within the program so as not to alter or defer significantly from the agreed upon performance targets, milestones and major deliverables
Leads communication with authority with individuals and groups in a manner that engages and helps them understand and retain information, drive decision making, achieve consensus and define/reinforce expectations
Facilitates program scoping discussions, definition of program success measures, and setting of expectations for cross-functional program teams with a focus on business outcomes and benefit realization
Demonstrates deep understanding of Core Operations, Claims and Enrollment processes, deliverables, vendor partners and technology platforms
Monitors performance metrics and goals for assigned programs, including process measures, outcomes measures, financial measures and methodologies for implementing programs
Oversees direct reports’ interactions with functional counterparts and vendors in tracking inventory levels, Turn Around Times (TATs), and other key performance metrics in a timely and appropriately documented manner
Regularly assesses areas of responsibility for improvement opportunities, applies Business Analysis Best Practices, and establishes goals/performance targets to demonstrate measurements of success
Identifies and assesses risk and facilitates the creation of mitigation/contingencies strategies with relevant parties to address the exposure
Manages vendor funding requirements, forecast allocations and invoice reconciliation activities. Initiates requests for additional vendor funding as required.
Oversee the review, reconciliation, and approval of invoices for payment of services rendered by vendors and understand vendor billing process
Adheres to and consistently applies organizational and departmental policies, procedures, and protocols
Meets regularly with vendors, primarily via videoconferences, occasional site visits to assess productivity, quality, compliance
Articulates the goals and objectives of Molina Healthcare business units to vendors supporting operations of those units
Assists in establishing standards to assess the performance of vendors
Oversee evaluation of vendor performance and compliance, including providing reporting and analytical data to Molina Healthcare leadership and key stakeholders.
Responsible for maintaining, enhancing relationship between Molina Healthcare and vendors; as needed implement corrective action plans to address non-performance
Job Qualifications
REQUIRED EDUCATION:
Bachelor’s degree in Business or a Related Field of Study. Years of experience in lieu of education is acceptable.
REQUIRED EXPERIENCE:
7+ years of experience in Healthcare (payer experience), Vendor Management, Data Analytics, Contract Terms and Conditions, Procurement, Project Management, or Account Management
Proficient with Microsoft Office Suite, databases, advanced spreadsheets, pivot tables, v-lookup and corporate email and collaboration solutions
Demonstrate strong written and verbal communication skills, presentations skills and ability to successfully interact with all levels of management
Exhibit excellent customer service skills and attention to detail.
Ability to problem solve and critically think to resolve business issues
Proficient in time management, organizational skills and managing multiple priorities
Operates independently in a matrixed organization and escalates issues and concerns as appropriate
PREFERRED EDUCATION:
Graduate degree
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $65,791.66 - $142,548.59 / ANNUAL
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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