Seeking Two (2) FACETS Vendor Service Deliver Consultants for a long term contract or possible contract to hire.
Our client has more than 5,000 employees and is the number 1 health insurer in the state of North Carolina serving more than 3.89 million customers. Our client's goal is to provide innovative solutions that simplify the health care system, improve efficiency and outcomes, and help rein in costs.
Position: FACETS Vendor Service Delivery Consultant
Term: 6 months +
- FACETS experience (navigating the system, review claims, understand workflow, etc.)
- Medical reimbursement policy understanding and working with configuration of concepts.
- Strong collaboration skills (work with other teams to obtain required information, present information
- Prior experience as the Point of Contact with external vendors
- COP(Certified Outsourced Professional) would be nice to have but not required.
- prior experience with a Health Insurance company and/or a Payment Integrity Vendor
Implement and execute value-driven vendor partnerships through effective onboarding, business process alignment and operational performance reporting. Responsible for ensuring that value is achieved as anticipated from smaller and/or less complex outsourced relationships. Serve as liaison between applicable business leads, vendors and Corporate Services to identify service needs, provide inputs to vendor contracts and provide issue resolution support. Monitor vendor services and performance against contracted service levels, maintain quality, service availability and efficiency, and take corrective action if needed to address deficiencies.
- Manage day to day relationship between business and vendor(s) to ensure seamless and effective delivery of outsourced services.
- Primary communicator/liaison between vendor and business stakeholders to answer questions, provide performance metrics updates, manage capacity and demand, and remediate escalations as needed.
- Facilitate vendor onboarding process through effective communications, site visits and training to educate the vendor on program/product/operational details and successfully transition business processes and/or operations.
- Partner with business leads to understand evolving service needs and expectations, define business requirements, and work with the vendor to improve capabilities.
- Establish and coordinate ongoing service level metric/performance reporting to monitor vendor performance and ensure contractual obligations and/or other performance agreements are met.
- Analyzes information to determine if there are gaps in performance and how to best address through process improvements, training and/or other interventions.
- Define internal process for handling high severity and stagnant issues/events; escalate and partner with Corporate Services for remediation as needed.
- Ensure adherence to standard procedures for vendor governance, including data access and security.
- Review vendor work for quality issues, design and administer customer surveys and other feedback processes and lead formal vendor service reviews and/or audits as needed.
- Provides inputs to vendor contract negotiations to ensure vendor contracts align to business strategy.
- Collaborate with Corporate Services on vendor strategy discussions, providing data, knowledge and feedback on vendor operations from the business perspective.