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Manager, Claims Vendor Management

Full-time

Jobgether

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Manager, Claims Vendor Management based in the United States. This role offers the opportunity to shape vendor strategy and improve operational performance across a diverse claims ecosystem. You will oversee strategic vendor relationships, with a particular focus on managed care services and medical cost containment. Working closely with Claims leadership and cross-functional partners, you will drive sourcing initiatives, contract negotiations, and vendor performance improvements. You will help identify cost-saving opportunities, streamline billing practices, and strengthen accountability across vendor categories. The position combines analytical thinking, relationship management, and strategic execution to improve claims outcomes and operational efficiency. You will also contribute to the development of vendor management frameworks, processes, and standards in a collaborative, remote-first environment. This is an opportunity to make a measurable impact on vendor value, compliance, and the overall claims experience. Accountabilities - Support the implementation and ongoing development of the claims vendor management program, including vendor governance frameworks, performance standards, policies, and centralized contract records. - Oversee managed care vendors providing medical bill review, pharmacy benefit management, utilization review, and provider network services, ensuring quality, contractual compliance, and alignment with medical cost containment objectives. - Manage strategic relationships across legal services, law firms, litigation support, investigative services, transportation, translation, and API-integrated technology vendors. - Execute vendor strategy in partnership with Claims leadership, including identifying redundant or underperforming contracts, supporting vendor sunset initiatives, and conducting formal requests for proposals (RFPs).

- Lead contract negotiations, renewals, and renegotiations to secure competitive terms, improve service delivery, and generate cost savings. - Establish and monitor vendor performance indicators, coordinate quarterly or annual performance reviews, gather stakeholder feedback, and evaluate vendor spending and service quality. - Conduct or support vendor billing audits and spend reviews to identify discrepancies, incorrect billing practices, and additional cost optimization opportunities. - Implement improved billing and bulk billing practices, ensuring adherence to contractual obligations and enterprise standards. - Collaborate with Claims Operations, Claims Adjudication, Regulatory Compliance, Legal, Finance, Procurement, and managed care leadership on contracts, budgets, compliance, operational needs, and strategic initiatives. - Apply project management skills to coordinate initiatives, track progress, communicate updates, and support team development and mentoring. Requirements: - Bachelor's degree in Business Administration, Finance, Supply Chain Management, or a related field. - At least 6 years of experience in vendor management, procurement, or strategic sourcing. - At least 3 years of experience in the insurance industry, preferably in claims operations or vendor management. - At least 1 year of experience leading or mentoring team members; direct people management experience is an advantage. - Demonstrated success in vendor contract negotiations, cost reduction, and implementing or supporting vendor management programs. - Strong understanding of the workers' compensation and managed care vendor landscape, including medical bill review, pharmacy benefit management, utilization review, and provider networks.

Vacancy posted 2 days ago
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