Senior Vendor Compliance Program Manager

Site: Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

In collaboration with the Senior Director, Government programs, manage the vendor oversight programs for government payer programs (Medicare Advantage, Part D, Dual Special Needs Programs) and then state insurance programs. Set up the vendor oversight models, intake monitoring performance reports and evaluate compliance and initiate corrective action and/or process improvement activities. Collaborate with the business to set up oversight model that ensures all services delegates are managed in a compliant and timely way.

Essential Functions:

• Managed vendor corrective action plan processes
• Conduct annual compliance risk assessment of vendors and use results to help craft annual monitoring and auditing program
• Perform annual outreach to vendors to validate its adherence to several federal vendor requirements
• Perform monthly checks of vendor information against government exclusion lists to ensure vendors are eligible for government program participation and payment
• Ensure vendors are prepared to participate in external audits with regulatory agencies

Qualifications

Education

• Bachelor's Degree Related Field of Study required and Master's Degree Related Field of Study preferred. Experience can be substituted in lieu of a dgree

Licenses and Credentials

• Any certification in health care compliance preferred.

Experience

• At least 8-10 years of program management experience required
• At least 1-2 years of team leadership experience required

Knowledge, Skills, and Abilities

• Strong oral and written communication skills.
• Ability to deliver presentations to a wide variety of audiences.
• Ability to effectively plan and facilitate meetings and workgroups.
• Excellent organizational skills and attention to detail, ability to work independently, manage multiple tasks and projects, meet deadlines, and manage a schedule.

Additional Job Details (if applicable)

Working Conditions

• This is a hybrid role that requires an on-site presence at the office in Assembly Row, Somerville, 2- 3x/month

Remote Type

Hybrid

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$97,510.40 - $141,804.00/Annual

Grade

8

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.