Senior Manager - Rental Network Manager

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Position Summary

Reporting to the Executive Director of Vendor Networks & Nonpar Solutions, the Senior Manager of Rental Network Management is accountable for driving operational excellence, owning strategic vendor partnerships, and overseeing business critical rental network operations.  The Senior Manager will be managing established rental network vendors, negotiating and executing Vendor contracts and amendments; conducting high level reviews and analysis relative to access, adequacy, utilization, access fee reporting, and/or settlement negotiations with rental network vendors and/or indirectly contracted providers, in accordance with company standards to maintain and enhance provider networks while meeting and exceeding access, quality, and financial targets.  This role manages contract performance and operational activities to ensure positive relationships with network providers, including accurate and current provider databases, policies and procedures, and vendor oversight.  Responsibilities include identifying and managing cost issues and collaborating cross functionally to execute cost saving initiatives.   Collaborates with internal partners to assess effectiveness of tactical plan in managing costs.  Ensures resolution of escalated issues related to claims payment, contract intent and parameters, or accuracy of provider contract and demographic information.

• Engages/manages compliance and regulatory requirements with vendors and their downstream providers.

• Facilitates highly cross-functional work (with PDS, MEU, Legal, PSS, Sales, Network, and others) to successfully develop and manage third-party vendor relationships. Responsibilities include, but are not limited to:
  • Researching potential vendor alternatives and conducting vendor partner selection process
  • Negotiating relationship parameters and contracts
  • Developing and executing on implementation plans
  • Ensuring operational/system readiness and integration
  • Managing and overseeing day-to-day operational activities
• Manages and participates in day-to-day oversight of current vendors by:
  • Managing root cause analysis regarding a variety of issues that confront the rental vendors and their downstream providers including operational, member concerns, and other areas; tracking these issues and communicating effectively with stakeholders.
  • Leading monthly Status Calls and/or Joint Operating Committees with each vendor.
  • Reviewing monthly reporting from vendors and sharing with appropriate internal stakeholders
  • Managing and/or overseeing (including Delegation Oversight) vendors' activities
• Ensures annual open enrollment readiness
• Serves as subject matter expert and point person to direct, triage and support both provider complaints and member escalations. Will facilitate remediation with internal and external constituents
• Creates solutions and develops the automation in Alteryx, Excel, and/or PowerBI
• Analyzes data to determine root causes to results and create prudent initiatives to solve pain points
• Provides forecasting/modeling support
• Coordinates efforts from all constituents to create the optimal solution  
• Some travel may be required on a periodic basis

Required Job Qualifications

• Knowledge of current health insurance marketplace and terminology
• Proven working knowledge of provider financial and operational issues as they relate to health insurance
• Consistently meets deadlines, works well under pressure, and keen organizational awareness.
• Strong verbal, visual, and written communication skills to interact with all levels of corporate personnel, clients, and providers.

• Proven project management of multiple complex projects simultaneously
• Proactively works with business partners asking thoughtful thorough questions to understand the root cause of the issues
• Strong communication, critical thinking, problem resolution and interpersonal skills
• Ability to multi-task, prioritize and meet deadlines
• Minimum of 5 years related ex