Clinical Vendor Manager

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October 13

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Gravie

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Healthcare Insurance • Fintech • B2B

Gravie is a company specializing in providing innovative health benefits and insurance solutions. Their offerings include the Comfort health plan, which simplifies health coverage with no deductibles and zero copays on common healthcare services. Gravie also provides Individual Coverage Health Reimbursement Arrangements (ICHRA) and Gravie Pay, a support system for managing healthcare costs. The company emphasizes clear and straightforward benefits that facilitate preventive care and reduce unexpected healthcare expenses, catering to both individual members and small to midsize businesses. Gravie aims to make health benefits accessible, understandable, and cost-effective for employers and employees alike.

51 - 200 employees

⚕️ Healthcare Insurance

💳 Fintech

🤝 B2B

📋 Description

• Serve as the primary point of contact for clinical vendors (including Cigna UM & CM, AHH UM & CM, Teladoc, Sword Health, Alight, and SL partners). • Maintain strong, collaborative relationships to ensure mutual accountability and continuous improvement. • Partner with internal clinical, finance, and operations teams to align vendor services with Gravie’s goals. • Strategize and evaluate potential clinical vendors to identify partnerships that add measurable value and align with organizational goals. • Monitor vendor performance against SLAs, KPIs, and contract terms; escalate issues and track remediation plans. • Manage ongoing and annual vendor evaluations, including data reviews and performance scorecards. • Identify performance gaps and opportunities for cost containment and quality improvement. • Support contract renewals, amendments, and performance guarantees (PGs) in partnership with Legal and Procurement. • Ensure vendor compliance with contractual, regulatory, and audit requirements. • Track key contract dates and coordinate renewal reviews and approvals. • Define and enforce clinical vendor data reporting standards and integration requirements across systems. • Prepare regular dashboards and summaries highlighting performance trends, risks, and opportunities. • Translate data insights into actionable recommendations for leadership. • Support decisions on insourcing vs. outsourcing functions by assessing cost, quality, and efficiency impacts. • Reconcile vendor invoices and proactively forecast clinical vendor spend. • Collaborate cross-functionally to resolve issues affecting member experience or clinical outcomes.

🎯 Requirements

• Active and non restricted RN license • 3+ years experience managing clinical vendors (UM/CM, telehealth, care navigation, etc.) in payer or managed care settings. • Demonstrated success improving vendor performance and managing complex contracts. • Working for a TPA and/or Self funded insurance organizations. • Working with Stop Loss and Reinsurance vendor partners. • Strong organizational and project management skills. • Excellent relationship-building and communication abilities. • Proficiency in data analysis and vendor performance dashboards. • Knowledge of healthcare quality, utilization management, and medical cost containment. • Comfortable working in a fast-paced, evolving environment.

🏖️ Benefits

• alternative medicine coverage • flexible PTO • up to 16 weeks paid parental leave • paid holidays • 401k program • cell phone reimbursement • transportation perks • education reimbursement • 1 week of paid paw-ternity leave