Director, Vendor Management and Participant Direction (ABHNJ)

Job Description

Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Director of Vendor Management and Participant Direction is responsible for the monitoring and oversight of all ABHNJ vendors and all aspects of participant direction operations. The Director of Vendor Management and Participant Direction reports to the ABHNJ Chief Operating Officer and will work in close partnership with the ABHNJ CMO, CFO, MLTSS Director, Integrated Case Management Director, Medicaid Operations and Performance Medicaid Vendor Management Director, and all matrixed growth partners. Successful candidate must live in New Jersey or be willing to relocate.

Responsibilities include:

• Establishing an end-to-end process to ensure all vendor agreements are implemented and services provided
• Managing oversight of all ABHNJ vendors in consultation with Medicaid Vendor Management Director
• Managing the oversight of ABHNJ’ s self-direction vendor including operations and service delivery, enrollment, eligibility, fiscal intermediary operations, payments, communications, and coordination of services.
• Serving as liaison between ABHNJ and NJ Medicaid on self-direction
• Providing routine monitoring and oversight of all ABHNJ vendors
• Documenting and monitoring corrective actions taken to address identified deficiencies and maintaining compliance
• Developing and implementing a vendor performance program that includes analytics/metrics that measure value, development of Key Performance Indicators (KPIs) to measure performance and drive business goals and improvements.
• Collaborating with Quality Management and Medicaid Compliance teams as needed for any related state or federal audits.
• Supporting Operations, IT, Finance, and other key departments with vendor management set up and reimbursement
• Ensuring vendors are delivering and performing to expectations of service levels and contractual terms.
• Leading escalations related to vendor risk management and resolution.
• Updating senior management of vendor activities and completing all mandated state reports

Required Qualifications

• At least three (5) years of experience in NJ Medicaid Managed care
• Strong analytical and communication skills (written and verbal)
• Experience in vendor management or delegation oversight activities
• Demonstrate clear ability to apply critical thinking, strategy development, and vision towards the growth of vendor relationship management plans, while also overseeing the day-to-day execution in a high volume, fast paced environment.
• Ability to communicate effectively with all levels of the organization and with our state partners
• Excellent organizational and time management skills

Preferred Qualifications

• N/A

Education
Bachelor’s degree or related experience.

Pay Range
The typical pay range for this role is: $100,000.00 – $231,500.00.

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 05/31/2024.