Senior Vendor Compliance Program Manager

Vendor Oversight Manager

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

Knowledge, Skills, and Abilities

Working Conditions

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

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.