Director Vendor Management (health benefits and/or insurance industry)
Church Pension Group Services Corporation
 New York, NY

This Director Vendor Management is accountable to lead, guide and direct the vendor management aspects of the benefit plans designed for employees and retirees of the Episcopal Church. The incumbent is the vendor relationship manager, responsible for coordinating and performing numerous plan administration activities, conducting performance analysis of the vendors and plans, and ensuring consistency in approach across all lines of business when others assume a subject matter related lead role with the vendors. This position will participate in and sometimes lead projects, typically driven by vendor related analysis such as requests for proposals that identify and lead to vendor engagement or renegotiation of contract terms, needs analysis, or other assignments necessary to research and resolve plan issues and provide data and business advice to support the strategic business plans as they relate to the third party vendor relationships. This position will have a direct connection with the Vender Management Officer (VMO) to ensure the Church Pension Group Vendor Management playbook is accurately applied to each vendor managed by Benefits Policy.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Demonstrated ability to make sound decisions and recommendations based on business judgment, established guidelines and individual circumstances and to provide support and documentation for conclusions
  • Solid knowledge and understanding of employer health plan marketplace
  • Experience with health benefit programs, policy and plan designs in order to approve benefit documentation, claims coding and plan handbooks with stake holders
  • Knowledge and experience with the legal and regulatory environment relating to health benefits and the ability to develop and finalize contracts in collaboration with TPA and corporate legal
  • Solid capabilities with vendor performance standards development, monitoring and enforcement
  • Experience in financial modeling and analysis of self-funded health benefit programs in order to manage RFI/RFP projects from development of questions through analysis phase and into recommendations of vendor finalists
  • Ability to prepare management and executive summary reports
  • Proactively develops effective business relationships with vendors, consultants, internal staff and key decision makers in order to facilitate plan performance and client satisfaction
  • Possess the ability to work collaboratively across all levels of the organization and with external clients and vendors
  • Must be tactful, discreet and professional in dealing with confidential/privacy matters
  • Intuitive sense of honesty and highest ethical standards; all actions and decisions are consistent with corporate values
  • Must be able to work on multiple tasks simultaneously, possess strong organizational and prioritizations skills, work independently and meet urgent deadlines
  • High computer proficiency in Microsoft Office applications
  • Excellent written and verbal communication skills, including strong presentation skills

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Oversees vendor selection, due diligence oversight, and maintenance of vendor relationships
    • Execute overall vendor relationship strategy by organizing, conducting and facilitating formal and informal meetings between vendors and internal staff for ongoing maintenance of our account
    • Identifies and monitors vendor concerns, recommends solutions and follow ups during the process to communicate resolution and ensure problem resolution occurs
    • Lead and review all levels of the vendor relationship to include: vendor service and performance levels; claims, benefits and plan performance; exchange of information; assessment of reporting and program recommendations; plan design and product training; financial and data exchanges, clinical reporting and support, vendor summits and ongoing strategic discussion
    • Develop tools to evaluate vendors (upon contracting/negotiations, during market checks and annual reviews); establish vendor competencies and capabilities (current and prospective) and related performance scorecards; solicit feedback, assess performance and distribute reports to key stake holders
    • Conduct assessments of vendor products, services and other capabilities to identify short and long term strategic opportunities with vendors for program and service enhancements, cost saving initiatives, and engagement and steerage opportunities, pursuing and suggesting alternatives that drive robust benefits with cost control mechanisms
    • Lead and direct third party administrators and internal personnel pertaining to ongoing negotiations, renewals and structure of contract terms ensuring a smooth execution of all contracts, amendments and modifications; recommend alternative strategies that will maintain and advance CPGs strategic business plan based upon relationships established with vendors and understanding of capabilities and limitations.
    • Responsible for new vendor implementations, products and services; ensures that work plan is kept on track, and operational issues are identified and resolved up front prior to going live; delivers projects on time and on budget
    • Provide oversight and intervention to ensure vendor performance supports all functional areas of CPG that interact with vendors (including but not limited to vendors being fully compliant and supporting through systems and others controls the accurate coding of benefits, claims, structure, enrollment, reporting etc. so that the plans perform to intent).
  • Work with Compliance and Legal to ensure policies and procedures are addressed and documented, and that vendors are compliant with all regulatory and legal requirements; ensure legal status as a Voluntary Employee Benefit Association is not compromised
  • Employs effective and proactive relationship management and communication practices to strengthen vendor and internal staff client relationships
  • Perform reviews and assist with vendor analysis as part of annual product array and vendor changes that impact the renewal process, ensuring all downstream changes are completed accurately
  • Participates in annual open enrollment assignments
  • Facilitate regular communications and training opportunities occur between staff and vendors to ensure knowledge of vendor websites, materials, current events, and other items impacting the day to day business are conveyed to all internal stakeholders
  • In conjunction with the Director Clinical Management determine the annual vendor claims audit plan (type, scope, vendor and timeline). Perform any associated tasks for audit completion including but not limited to the procurement, contracting and coordination of the vendor relationship, on site participation, audit findings report review and analysis as well as oversight of the vendor remediation and corrective action plan recommendations as a result of findings.
  • Other duties deemed necessary and appropriate as assigned.

EDUCATION & EXPERIENCE:

  • Bachelor’s degree
  • 8+ years of professional vendor management experience is required in or related to the heath benefits and/or insurance industry with increasing responsibility.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Use of computer input devices, e.g., mouse, keyboard, etc.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Professional office environment
  • Home office
  • May require some travel

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Please understand that, as a general policy, CPG does not sponsor visas.

EOE: Minorities/Female/Disability/Vet/Sexual Orientation

If you are a CPG employee, please use your CPG email address when creating your profile to apply.

This position reports to our corporate office at 19 E. 34 Street in New York, NY. However, due to the Covid-19 pandemic, CPG employees have been working remotely since March 2020 and will return to the office sometime after August 2021. The official date has not been announced.

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