Healthcare Payor Network Manager (Sr. Program Manager) - HYBRID

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

Bundles Prog Mgmt

Job Summary:

JOB SUMMARY
Provides leadership and support for the creation, coordination, execution, and growth of value-based sales and management of employer engagement related to MyHealthBundles program independently. Provides leadership to support programs that are expected to experience significant change, expansion or evolution over time. Maintains awareness of the healthcare marketplace and provides feedback to leadership on impact to sales and growth. Promotes the growth of sales and stakeholder engagement by representing the MyHealthBundles Product line directly to employers.

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KEY RESPONSIBILITIES

• Applies knowledge and awareness of healthcare payor operations surrounding health benefits to grow the MyHealth Program.
• Develops program plans, goals, and objectives in collaboration with program and area leadership.
• Health Care Operations Knowledge (Intermediate): Awareness of the activities that are necessary to support the core functions of a healthcare organization.
• Provides professional and/or technical leadership in the execution of day-to-day program activities.
• Communication (Advanced): Communicates within and across departments to maximize information sharing around progress, needs, interdependencies, and accomplishments with excellent interpersonal, verbal, presentation, and written communication.
• Insurance Regulatory Knowledge (Intermediate): Demonstrates knowledge of the appropriate rules and regulations for insurance policies, claims, payment, and coverage.
• Manage accounts of all sizes by representing MyHealthBundle products and departmental goals working closely with supporting positions and leadership.
• Establish and build strong working relationships with key stakeholders.
• Seek and utilize key market data and information to handle objections, drive sales, and access new opportunities to meet sales goals and objectives.
• As necessary, visit clients and attend key meetings and industry events to capitalize on networking relationship-building opportunities.
• Maintains database to track and manage operational issues for each stakeholder
• Identifies and discusses concerns or trends with teams and payors to improve related operational processes and resolve issues.
• Manages single case agreements.
• Demonstrates knowledge of payor operations in healthcare and applies them to complex situations.
•  Contract Interpretation (Intermediate) Understanding and making educated decisions based on the reasonable interpretation of a contact's intent and provisions
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES

• Quality Management (Advanced): Developing a systematic process of checking to see whether a process or service is meeting specific requirements.
• Networking (Advanced): Build relationships through industry contacts, professional organizations, and individuals.
• Peer Leadership (Intermediate): The ability to show leadership and influence people of equal rank to accomplish team and organizational goals.
• Process Improvement (Advanced): Identifies, analyzes and improves upon existing business processes for optimization and to meet standards of quality.
• Mentoring & Coaching (Intermediate): The essence of training and mentoring on the job is transfer of knowledge. Whereas training can be considered more formal and scheduled, mentoring is often in the form of guidance and "hands-on" experiences. The reporting relationship is unimportant since the purpose is to pass on information and experiences. These discussions normally center around a person's goal of learning job procedures, content, standards, analysis and proble