• Supervisor, Vendor Support

    Job Locations US-VA-Glen Allen
    Job ID
    2018-4861
  • About Us

    Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.
    By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.
     
    At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.
     
    If this sounds like you, read on!

    Overview

    The Vendor Support Supervisor is responsible for, providing daily oversight of all operations and care coordination activities performed by vendors, and supporting leadership in program enhancements.

    Responsibilities

    • Supervises day-to-day model of care (MOC) activities performed by care coordination vendors for the MLTSS program including assessments, individualized care plans, interdisciplinary care team meetings, and care coordination.
    • Collaborates with the vendor to maintain appropriate staffing levels and assignments to ensure excellent customer service and meet regulatory timeframes.
    • Works with care coordination team to provide guidance and/or intervention in problematic/unusual cases.
    • Assists with onboarding and performing ongoing mentoring/coaching with vendor care coordination staff.
    • Monitors metrics and develops action plans for care coordination vendors to meet regulatory requirements.
    • Leads regular operational and clinical meetings with care coordination vendors.
    • Ensures vendor policies, procedures, and workflows reflect contractual requirements.
    • Serves in an advisory capacity for problem solving, reviews reports sent to internal and external customers, reviews problematic cases, and monitor medical management activities in collaboration with the vendor and medical management staff.
    • Maintains resources, keeping information up-to-date.
    • Supports ongoing quality improvement initiatives by assisting with various review tasks such as collecting and analyzing data as outlined in the program.
    • Participates in assigned VPHP meetings to educate providers and/or members (which may occur outside of normal business hours).
    • Assists in the ongoing development of programs and care coordination projects to enhance/expand the department.
    • Maintains confidentiality of patient information, and VPHP proprietary operational information.
    • Maintains current knowledge of VPHP policies and procedures.
    • Participates in continuing education activities as appropriate.
    • Other duties as assigned

    Qualifications

    EDUCATION/CERTIFICATION REQUIREMENTS

    • Bachelor’s Degree or equivalent experience

    SPECIAL KNOWLEDGE AND/OR SKILLS 

    • Strong oral and written communication skills
    • Possess knowledge of Medicare and Medicaid programs
    • Project or vendor management experience preferred
    • Proficient in Microsoft Office computer applications such as Excel, Outlook, Word, and Power Point
    • Experience leading cross functional business teams
    • Strong analytical skills

    WORK BACKGROUND/EXPERIENCE  

    • Prior supervisory experience is preferred
    • Knowledge of managed care operations, and/or business analysis
    • Experience managing service level agreements preferred

    PHYSICAL REQUIREMENTS

    • Physical health sufficient to meet the ergonomic standards and demands of the position.
    • Some local travel will be needed.  

    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

     

    Our mission is to inspire healthy living within the communities we serve!

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