The Vendor Relationship Specialist is responsible for the day -to -day management of the Healthfirst Delegated Vendors. The Delegated Vendor Specialist will support the vendor management processes and programs at Healthfirst to ensure that contractual and regulatory requirements are met.

This position is Remote

Duties & Responsibilities :

• Monitor delegated vendor and internal business owner relationships to ensure compliance, optimal delegate performance, and achievement of business goals according to Service Level Agreements (SLAs), and other contractual requirements
• Maintain highly effective working relationships with delegated vendors and internal business stakeholders to ensure performance metrics are met, identify opportunities for improvement, mitigate risk, and eliminate barriers to correct Corrective Action Plans (CAPs)
• Monitor and report instances of vendor CAPs and implement CAPs as necessary
• Serve as Liaison between vendors and cross-functional internal departments and teams to ensure timely and quality deliverables from vendors and internal departments
• Provide Manager with performance data on vendors based on contractual requirements and SLAs on a monthly / quarterly basis
• Participate in Vendor Performance Committee, Joint Operating Committee, and other meetings or activities as directed
• Analyze, track, and follow up on the timely resolution of errors and issues that are a result of vendor processes, and as necessary escalate unresolved inquiries / complaints to Manager.
• Maintain and update tracking logs and other resources used to track or monitor delegated vendor performance
• Assist Manager with NYS DOH, CMS and other internal / external audit requests as needed
• Assist in implementation strategies to increase delegated vendor engagement strategies for HEDIS and STARS Quality Initiatives
• Analyze, update, and modify procedures and processes to continually improve operations
• Support manager in coordinating audit documentation and submissions as it relates to compliance with state and federal requirements
• Perform other duties as assigned or necessary

Minimum Qualifications :

• Demonstrated strong organizational, analytical, and interpersonal skills with detail-oriented focus
• Demonstrated computer proficiency, including but not limited to, Microsoft Outlook and Microsoft Office Word and Excel
• MS Excel proficiency with the ability to create formulas, v-lookups, pivot tables and analyze data
• Demonstrated ability at planning, organizing, and executing
• HS Diploma or GED from an accredited program

Preferred Qualifications :

• Knowledge of health insurance / healthcare / managed care environment
• Experience with Vendor Relationship / Account Management
• Experience with Appeals & Grievance and Claims
• Effective verbal and written communication skills
• Bachelor's Degree or higher from an accredited institution

Compliance & Regulatory Responsibilities : Noted above

License / Certification : N / A

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State / Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to or calling 212-519-1798 .

In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying.

Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied.

All hiring and recruitment at Healthfirst is transacted with a valid email address only or from a recruitment firm representing our Company.

Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about.

If you receive a communication from a sender whose domain is not , or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst.

Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range* :

Greater New York City Area (NY, NJ, CT residents) : $67,200 - $97,155

All Other Locations (within approved locations) : $59,800 - $88,910

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements).

Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

• The hiring range is defined as the lowest and highest salaries that Healthfirst in good faith would pay to a new hire, or for a job promotion, or transfer into this role.

Last updated : 2024-05-10