Quality Vendor Economics Analyst III

Job Summary:

The Quality Vendor Economics Analyst III serves as subject matter expert in assessing Quality vendor value and monitoring vendor performance. The Quality Vendor Economics Analyst will support the Quality Vendor team in conducting impact analysis of vendor relationships. They will also document and educate CareSource staff on end-to-end Quality vendor processes.

Essential Functions:

• Assist in the identification of new Quality vendors and then assess the financial opportunity associated with implementing the vendors or renegotiating current vendor contracts
• Document Quality vendor processes and address process gaps.
• Partner with Strategic Sourcing on the contractual financial model development, including but not limited to the development of financial targets and reimbursement methodologies
• Develop and apply methods used to establish and/or measure contract performance
• Maintain member volume and potential spend vendor forecasting on a regular frequency. Track to provide Accounting and Finance vendor performance bonus and penalty progress and results.
• Act as liaison between CareSource and vendors to ensure performance metrics are met or exceeded.
• Participate in creating business requirements for the development of automation reporting processes.
• Develop presentations for Sr. Leadership communicating vendor status and opportunity
• Support Accounting, Disbursement Services, and Actuary by supplying performance forecasts, cost accruals, and invoice submission and validation
• Lead and participate in efforts to identify, quantify and prioritize opportunities to utilize vendors to improve quality measurements
• Build and maintain collaborative and productive relationships with internal and external stakeholders
• Perform any other job-related instructions as requested

Education and Experience:

• Bachelor's degree or equivalent years of relevant work experience is required
• Minimum of five (5) years of experience related to the responsibilities of the role is required

Competencies, Knowledge and Skills:

• Proficient use of Microsoft Office Suite, to include Word, Excel and PowerPoint; Strong use of Visio.
• Knowledge in SAS or SQL
• Proficient in forecasting and data analysis.
• Exceptional problem solving and critical thinking skills
• Ability to lead in a hands-on capacity
• Influence leaders of the business and small teams without direct authority.
• Ability to manage multiple priorities within a dynamic environment
• Knowledge of managed care operations
• Knowledge of government healthcare programs
• Knowledge of or ability to learn healthcare quality programs and measures (e.g. CMS, HEDIS, NCQA)
• Ability to create strong working relationships with others
• Strong understanding ROI, risks and controls
• Understanding of cross-functional processes
• Work independently and collaboratively
• Gather and review data to make informed decision

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:
$81,400.00 - $130,200.00 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:
Salary

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.

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