Note: The job is a remote job and is open to candidates in USA. Quantum Health is a healthcare navigation organization committed to simplifying the healthcare process for its members. The Clinical Vendor Program Manager will lead the strategic direction and performance management of clinical vendors, ensuring alignment with enterprise growth and client objectives while optimizing vendor program offerings.
Responsibilities
- Shapes the enterprise's preferred partnership strategy roadmap to align with corporate growth objectives and emerging healthcare market trends
- Proactively identify, evaluate, and onboard clinical vendors that align with population data insights and market demands. Directs and assists leadership in deciding whether to add, replace, or terminate a service line to ensure current offerings support organizational and clients' needs
- Develop and maintain a comprehensive multi-year roadmap including areas of exploration and implementation targets
- Ensure alignment with organizational and clinical and market strategies, ensuring quality, cost-effectiveness, and compliance
- Lead contract negotiations by establishing service level agreements (SLAs) and performance guarantees (PGs) to ensure cost-effective vendor partnerships while maintaining high-quality service delivery. Develop, in conjunction with Finance, the revenue model. Creates and finalizes all Program Descriptions and Order Forms for market launch and ongoing maintenance
- Develop and implement key performance indicators (KPIs) and benchmarks to assess vendor performance, drive accountability, and ensure project goals for data integration, engagement, and clinical outcomes are achieved
- Proactively identify and address vendor-related challenges, ensuring seamless operations and alignment with organizational and client objectives. Monitor contract terms and conduct proper oversight
- Identify and implement opportunities to enhance vendor management processes, streamline workflows, and improve efficiency in clinical service delivery. Oversight of external and internally sourced data management to include vendor reports to ensure reporting supports clinical strategy and messaging
- Draft the development of technical business requirements for project success. This includes defining project objectives, expected outcomes, resource requirements, and evaluation strategies to ensure vendor program effectiveness
- Maintains regular communication with clinical vendors as the primary interface and business owner to review their strategic roadmaps and integration capabilities and develop joint operating committee infrastructure with vendors to regularly evaluate performance and drive vendor expectations
- Partner with sales, technical, legal, procurement, and finance teams to optimize vendor strategies and integration within systems that support and align with clinical strategies
- Present data and information to internal and external stakeholders by applying clinical knowledge and the use of healthcare data to drive decisions to help organizational leaders understand the clinical impact of these solutions. Serves as a subject matter expert with key clients, driving consultative discussions to influence adoption and retention of clinical vendor solutions
- Partner with sales and marketing to conduct joint marketing engagement opportunities with clients and vendors. This may include marketing campaigns and vendor summits
- Partner with training to drive organizational awareness of clinical vendors to drive engagement and effectiveness of vendor solutions
- Accountable for vendor compliance with regulatory requirements (e.g., CMS, HIPAA, NCQA, URAC as applicable) and internal policies to mitigate potential risks within the payer environment
- Business owner to ensure appropriate contracts in place (e.g., BAA, NDA, and Service Agreements). Directs contracting with accountability for service level agreements (SLAs), performance guarantees (PGs), and financial impact
- Oversees vendor compliance with all contract provisions
- Report to legal and risk any potential compliance or regulatory issues
Skills
- Bachelor's degree in Health Administration or a health-related field that delivers a strong clinical knowledge base
- Minimum 3-5 years of experience in vendor management within a payer, medical management, or healthcare operations environment
- Proven track record of managing multimillion-dollar vendor portfolios
- Proven ability to negotiate contracts and manage relationships with clinical solution vendors
- Strong analytical skills with the ability to interpret complex clinical data and translate it into presentations and actionable insights
- Excellent problem-solving and decision-making skills
- Exceptional presentation and communication skills, with experience presenting to clients
- Ability to work collaboratively with cross-functional teams and external clients and consultants
- Strong organizational skills and the ability to manage multiple projects simultaneously
- Experience with budget forecasting and financial oversight of vendor contracts
- Experience managing clinical technology solutions or care management platforms in a medical management environment
- Strong understanding of medical management/clinical operations, clinical programs, and regulatory requirements
- A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health's policies, values and ethics, and to protecting the sensitive data entrusted to us
- Master's preferred
- RN licensure preferred
- Certification in Case Management (e.g., CCM), Healthcare Management (e.g., CPHQ, CHC), or Procurement (e.g., CPSM) is advantageous
- Proficiency in vendor management software and payer-related systems is a plus
Benefits
- Competitive base and incentive compensation
- Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.
- 401(k) plan with up to 4% employer match and full vesting on day one.
- Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.
- Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.
- Recognition as a Best Place to Work for 15+ years, dedication to diversity, philanthropy and sustainability, and people-first values that drive every decision.
- A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more!
Company Overview