[Remote] Senior Vendor Management Professional at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's degree or equivalent experience
3+ years of demonstrated vendor management experience
Familiarity with procurement and contracting processes
Experience over a large metric-intensive operational unit
Proficiency in Microsoft Office applications (Word, Excel, PowerPoint)
Strong verbal and written communication skills
Strong facilitation skills
Passion for contributing to an organization focused on continuously improving consumer experiences
Prior experience in a healthcare or insurance setting, preferably in operations

Responsibilities

Work as a liaison between vendors and Humana
Support internal business areas while ensuring vendors meet contractual obligations as part of the Medicare Prescription Payment Plan program
Build and maintain positive relationships with vendors
Monitor vendor activities (SLA's, reporting, system reliability, and CMS compliance)
Facilitate meetings with vendors to monitor business activity
Conduct quarterly business review meetings to discuss performance
Investigate escalated vendor concerns and collaborate with internal business partners and vendors to ensure resolution
Monitor all M3P vendors budget vs actual spend and address any billing discrepancies
Provide details to the Finance team
Support system monitoring, file transmissions, member communications, call center inquiries, and production issues resolution
Work well independently and as part of a project team in determining objectives and approaches to assignments
Assist with quality assurance and user acceptance testing
Collaborate with the Risk and Compliance team to ensure vendors are in compliance with CMS regulations

Skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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