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Job Description
Position Purpose
This role liaises between third party vendors and Health Plan Operations team and will be instrumental in Vendor Engagement, Onboarding Management, Performance Management and assist leadership team in Vendor Management Process & Strategy.
This position does not provide patient care.
Nature and Scope
Essential to success in this role :
Have a solid understanding of the business and operational aspects within Renown Health entities.
Demonstrates the ability to work on multiple and more complex tasks with high quality results and adherence to deadlines with guidance.
Attention to detail, persistence and perseverance in the pursuit of quality work output
Proven positive track record in organization wide transformation and scaling.
A willingness to learn about what makes organization operate and how to get adoption of best practices.
Experience working closely with a variety of cross-functional specialists and leaders.
Very strong collaboration, influencing, prioritization, and time management skills.
Ability to set up, prioritize and evangelize process changes
Ability to showcase eye for business, along with excellent problem-solving skills, working collaboratively across teams undergoing large-scale change.
Data gathering and analysis capabilities
Strong communication skills and a consistent track record of building and developing relationships with stakeholders.
Scope:
Support the organization through strategic operations implementation and deliverables. Be prepared to represent the needs and impact on our business including cost benefit analysis.
Collect information regarding potential enhancement needs, and analyze new functionality in releases to determine how/if it should be used, and review and test each new release.
Partner with Operations, IT and business functions to align on the full scope of changes required to enable new and/or improved business capabilities and metrics
Liaise between business stakeholders to ensure business requirements are defined, clearly documented, and addressed.
Perform analysis of workflows, data collection, report details, and other technical issues associated with assigned initiative with some supervision.
Manage vendor relationships including vendor performance monitoring against service level agreements (SLAs) and issue resolution and progressive service enhancements.
Manage on-boarding/off-boarding for third party vendors through the application of project management methodologies
Coordinate operational acceptance of improvements or changes to ensure accuracy, quality and timeliness of implementation to existing operational system, processes, or partners.
Assist with the translation of business unit strategies into capability impacts with attention to regulatory compliance and support RFP processes.
Continually monitor and prioritize opportunities and work with leadership to ensure alignment of strategies and priorities.
Continuously improve and optimize the function by monitoring performance, steadily raising expectations, and adjusting the organization and business processes to achieve results.
Effectively balances competing constraints between business priorities and Operations objectives, using creativity to achieve both as much as practical.
Establish communication process to keep leadership informed with detailed and accurate updates
Partner with cross functional peers to align and standardize strategies/approaches where possible
Utilize good program management practices to ensure initiative are managed on time, in scope and within budget.
Ensure end-to-end adoption through appropriate documentation, change management methodologies, and education engagements.
Manage the make versus buy process for specific business requests.
Disclaimer
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications
Requirements – Required and/or Preferred
Name
Description
Education:
Must have working-level knowledge of the English language, including reading, writing and speaking English. Bachelors degree in Business Management, Operations, Healthcare, Engineering, IT or related field required or equivalent combination of education, training, and experience.
Experience:
Minimum two years experience in compliance within the health insurance industry or health care, preferred. Experience with Medicare Advantage plans or Medicare Managed Care preferred. Minimum five years experience in operations discipline, experience in manufacturing and/or technology industries preferred.
License(s):
None
Certification(s):
Project Management Professional (PMP) certification Preferred
Computer / Typing:
Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Typing 35 WPM.
