Manager, Vendor Management

Centene

Job Details

Location: Charlotte, Mecklenburg County, North Carolina, USA Posted: Nov 08, 2019

Job Description

Position Purpose: Manage all aspects of vendor activity, including but not limited to dental, ancillary, behavioral health, pharmacy and vision vendors for the Health Plan

Manage vendor utilization including work flows for coordinating services with the Health Plan

Analyze vendor data and complete required reports for the health plan, Corporate and state

Create and manage vendor scorecard and associated ratings/correction plans

Perform as a key account manager for the Health Plan to coordinate with high priority providers and vendors

Coordinate with Corporate Vendor Management team regarding vendor expectations, performance and procedures

Coordinate with various cross-functional departments to educate and communicate expectations, performance and procedures to vendors

Conduct monthly meetings and document discussions, issues, attendees, action items

Research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution

Ensure operation integrity, including compliance with all policies and procedures for the Health Plan including adherence to state contract and guidelines

Request and/or assist in the development of correction action plans for standards that are not met by the vendor

About Centene

Centene is a multi-line health care enterprise offering Medicaid managed care and specialty services.

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