CareSourceCA

Enterprise Quality Vendor Liaison

CareSource is a nonprofit managed care organization based in Dayton, Ohio, that serves over 2 million members with a wide array of Medicaid and Medicare products.

CareSource

Employee count: 1001-5000

Salary: 71k-113k USD

United States only

Job Summary:

The Enterprise Quality Vendor Liaison is responsible for supporting the oversight of the day-to-day operational activities for the Enterprise Quality Vendor programs. In addition, act as a liaison between Quality vendors and CareSource departments, including Compliance.

Essential Functions:

  • Manage day-to-day oversight of vendor programs.
  • Track vendor deliverables, action items and SLAs, problem management, trouble shoot & root cause analysis.
  • Monitor and analyze vendor calls & vendor complaints to identify patterns and drive improvements.
  • Manage large vendor data sets and develop data visualization
  • Research new vendor opportunities and provide analysis and/or recommendations to management.
  • Establish and maintain collaborative working relationships with the CareSource Corporate Compliance Department and other CareSource departments as needed.
  • Ensure timely and accurate compliance with all state and federal contract requirements, inquiries, review, and submission deadlines, and required reporting
  • Support new and existing business development opportunities
  • Coordinate department participation in federal and state contract and regulatory audits and site visits
  • Ensure department policies and procedures are accurate and translate into actionable business decisions
  • Recognize inconsistencies and gaps in complex business processes
  • Identify strategies and processes to improve vendor performance
  • Create reports and data-driven presentations
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor of Science/Arts (BS/BA) degree in business or related field or equivalent years of relevant work experience is required.
  • A minimum of five (5) years of experience in a managed care organization is required

Competencies, Knowledge and Skills:

  • Proven analytic skills
  • Proficient problem-solving skills with attention to detail
  • Proficient project management skills with ability to handle multiple projects within time constraints
  • Advanced proficiency in Word, Excel and PowerPoint; Power BI knowledge preferred
  • Effective verbal and written communication skills
  • Critical listening and thinking skills
  • Decision making and issue resolution skills
  • Understanding of database relationships preferred
  • Graphic development/presentation skills preferred
  • Ability to work independently and within a team environment
  • Knowledge of managed care preferred
  • Strong interpersonal skills and high level of professionalism
  • Ability to work with a variety of disciplines and levels of staff across departments

Licensure and Certification:

  • None

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time
  • May be required to travel – estimated at 25%

Compensation Range:

$70,800.00 - $113,200.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Create an Inclusive Environment

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Mid-level

Salary

Salary: 71k-113k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About CareSource

Learn more about CareSource and their company culture.

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CareSource is a nonprofit, nationally recognized managed care organization established in 1989 that has grown to serve over 2.1 million members across various states in the U.S. With its headquarters in Dayton, Ohio, CareSource administers one of the largest Medicaid managed care plans in the country. The organization offers a wide range of health insurance products, including Medicaid, Medicare Advantage, and Health Insurance Marketplace plans. CareSource stands apart by addressing the social determinants of health which significantly impact the well-being and health outcomes of its members. This mission-driven approach enables them to provide personalized care solutions that cater to the unique needs of low-income and vulnerable populations.

As part of its commitment to innovative care delivery, CareSource continually enhances its services through technology and partnerships designed to streamline access to care and improve member experiences. The organization employs nearly 5,000 individuals who are dedicated to fostering community relationships and ensuring that every member receives high-quality care when needed. Their strategic initiatives focus on improving health outcomes, operational excellence, and social equity within the healthcare realm. In addition to traditional medical services, CareSource actively engages in health education and outreach efforts that foster resilience and self-sufficiency in the communities they serve. This approach contributes to a broader aim of not just treating illness but promoting overall health and wellness in society.

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CareSource

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