Job Information
Cambia Health Solutions HCS Vendor Manager I or II (Healthcare) in Bellevue, Washington
HCS Vendor Manager (Level I or II) (HEALTHCARE) Work from home (telecommute) within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Payment Integrity - Support Services Team is living our mission to make health care easier and lives better. The Healthcare Services Vendor Manager provides support related to program evaluation, development, ensure regulatory compliance, implementation and management. Supports the implementation of new programs and the enhancement of existing programs delivered internally, through a vendor relationship, or in a hybrid model. Build and own relationships with internal customers in Healthcare Services management, vendors, vendor management and numerous departments within the company to achieve successful implementation of new or enhancement of existing programs - all in service of making our members' health journeys easier. If you're a motivated and experienced Vendor Manager looking to make a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Qualifications and Certifications: * Bachelor's degree in nursing, Health Care Administration, or related field * 5 years' experience with an area of focus (e.g. care management or utilization management) in healthcare insurance operations * Managing leading complete projects/programs and working with third party service providers * Or equivalent combination of education and experience. * Masters preferred. Previous leadership experience preferred. Skills and Attributes (Not limited to): * Ability to evaluate program effectiveness, identify issues and opportunities, and work to continuously improve programs offered. Ability to analyze financial measures associated with process improvement activities. * Strong communication and facilitation skills, including the ability to resolve issues with diplomacy and persuasiveness, and build consensus among groups of diverse stakeholders. * Ability to track and analyze performance data and translate data into insights for decision making. * Knowledge of health insurance industry trends and technology. * Experience in areas of Healthcare Services practices. * Extensive knowledge of CMS and state regulatory requirements and demonstrated ability to manage compliant operations. NCQA and/or HEDIS accreditation experience preferred. * Ability to coordinate cross-functionally to drive solutions and resolve issues in a timely and effective manner. * Demonstrated experience in complex program oversight. * Familiarity with contract language and understands and can identify contractual risk, with an ability to mitigate risk. * Demonstrated experience in designing and implementing process and technology improvement solutions. * Strong knowledge of data abstraction and quantitative, qualitative and analytical skills. * Ability to organize, plan, prioritize and execute several deliverables, simultaneously, within time constraints. * Demonstrated ability to think strategically and oversee detailed execution of strategies in order to move concepts forward into actionable items. * General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems. What You Will Do at Cambia (Not limited to): * Effectively collaborates with internal program leaders, vendors and/or a combination of internal and external resources to resolve implementation, compliance, and program design challenges. * In conjunction with internal operational leaders and/or vendor manageme To view the full job description,