Program Manager, Vendor Performance

🔥 14 hours ago

🇺🇸 United States – Remote

💵 $94.1k - $164.8k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📋 Program Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Manage and support initiatives to improve member interactions with plan services and benefits • Develop, monitor, and report on KPIs, SLAs, and operational dashboards • Lead operational reviews to identify trends, risks, and improvement opportunities • Coordinate implementation of new initiatives and operational processes • Support alignment of products and services with member needs, compliance, equity, accessibility, and quality • Monitor and evaluate the end-to-end product service experience and streamline operational workflows • Support development of policies, procedures, workflows, standard operating procedures, and business requirements • Serve as operational liaison for contracted service providers • Monitor vendor performance, resolve issues, facilitate communication, and ensure contractual alignment • Facilitate root-cause issue resolution among internal teams and external partners • Partner with operations, grievances and appeals, compliance, and clinical teams • Coordinate with external stakeholders, including vendors and regulatory partners • Support development and administration of training and communications related to DME, wheelchair repairs, and home modification • Analyze DME trends, costs, supplier volume, and supplier performance • Collaborate on materials for reviewing SLAs, KPIs, and status • Perform other related duties as requested

🎯 Requirements

• Bachelor's degree in healthcare management, business, or related field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Seven (7) years of experience in healthcare operations, member services, or product experience roles required • Experience supporting vendor management and service delivery improvement initiatives required • Working knowledge of DME services, healthcare regulations, and compliance requirements required • Experience using operational metrics, dashboards, and data analysis to drive performance improvements preferred • Strong communications, analytical, and organizational skills • Ability to coordinate multiple initiatives simultaneously while balancing competing priorities • Uses data, metrics, and performance trends to identify opportunities and recommend solutions • Ability to support process improvements and track measurable results • Ability to build effective working relationships internally and externally and build consensus • Commitment to improving member experience and outcomes • Knowledge of Medicare Advantage rules and regulations • Knowledge of MassHealth or other Medicaid program regulations • No licensure or certification required

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Equal Opportunity Employer environment fostering belonging and supporting individuals of all backgrounds